The Drug Enforcement Administration (DEA) is backing down from a much-criticized proposal that would have required patients to visit a doctor in person before receiving prescriptions for certain controlled substances via telemedicine. The rule change was set to go into effect after the COVID public health emergency expires later this week, but following an overwhelming public outcry, the DEA has extended its public comment period for another six months and will allow anyone who begins their telehealth treatment by that time to continue their care until November 2024.
“The DEA received a record 38,000 comments on its proposed telemedicine rules. We take those comments seriously and are considering them carefully,” DEA administrator Anne Milgram wrote in a statement. “We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities for six months while we work to find a way forward to give Americans that access with appropriate safeguards.”
Telehealth providers, particularly those who serve patients struggling with opioid use disorder, had warned of the potentially catastrophic effects of depriving patients of the virtual medical care they’d grown accustomed to. In an interview with Fast Company in March, Stephanie Papes Strong, CEO of the telehealth company Boulder Care, warned that the DEA’s changes could harm patients that her company serves—hundreds of whom live in remote areas, lack transportation, and don’t currently have a primary care provider. “The people who are struggling most in their addiction and in their lives are the very people who will struggle most with this rule,” Strong told Fast Company at the time.
Concerns about the rule’s impact on overdose prevention seem to have had an impact on the Biden administration’s decision. “We strongly support policies that promote access to effective and safe treatment for opioid use disorder, including through telemedicine platforms, and ensuring continued access to necessary controlled medications past the COVID-[public health emergency],” Miriam E. Delphin-Rittmon, administrator of the Substance Abuse and Mental Health Services Administration, wrote in a statement.
Now, Strong is praising the DEA’s decision. “We applaud the administration for taking additional time to ensure these critical policies are right,” she tells Fast Company. “For patients who rely on life-saving medications like buprenorphine, continued telemedicine access will make all the difference.”
The news also received approval from Zack Gray, CEO of the telemedicine company Ophelia, which also provides medication for people with opioid use disorder. “We are relieved that the DEA has recognized the gravity of its proposed rules,” Gray says. “The DEA’s original proposal [would have had] a negative and deathly impact on the millions of Americans who are struggling with [opioid use disorder].”
The new deadline doesn’t mean that the DEA will keep COVID-era flexibilities in place forever. At the end of the extended comment period in six months, the administration could very well decide to reinstitute the in-person visit requirement anyway. But the agency’s reaction suggests that it’s open to additional feedback and alternative approaches that can protect vulnerable patients, while also addressing the risks of overprescribing.
Strong of Boulder Care says the extended deadline will at least give regulators a chance to learn more about the positive impact of telehealth during the pandemic, time that was not originally afforded the DEA during its initial 30-day comment period. “Our strained U.S. healthcare system is at a crossroads,” Strong says. “If we double down on innovations that scale medical services quickly and affordably to people who need them, technology can help us create a more sustainable future.”
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