DEA Extends Pandemic-Era Waivers for Remote Prescribing of Controlled Substances

The Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Administration (SAMHSA) have issued a temporary rule that extends COVID-era waivers for the remote prescribing of controlled substances via telehealth through November 2023.

The rule, “Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications,” will go into effect on May 11 when the federal public health emergency (PHE) sunsets. This will extend flexibilities granted as part of the PHE to prescribe certain kinds of controlled substances used in mental healthcare via remote technologies, particularly telehealth.

The rule will extend through November 11, 2023.

Particularly, the rule will extend flexibilities that allowed substance use disorder (SUD) providers to prescribe drugs like buprenorphine, the gold-standard in medication-assisted treatment (MAT) for opioid use disorder (OUD), via telehealth.

“Access to evidence-based treatment is a pillar of the HHS Overdose Prevention Strategy,” Miriam E. Delphin-Rittmon, the HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA, said in a statement about the temporary rule. “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-PHE.”

This temporary rule comes after serious industry lobbying, with DEA Administrator Anne Milgrim saying the agency took those comments into account when creating the temporary extension.

“The DEA received a record 38,000 comments on its proposed telemedicine rules. We take those comments seriously and are considering them carefully,” said Administrator Milgram. “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.”

Leading industry group, American Telehealth Association, applauded the move.

“The ATA and ATA Action strongly commend the actions that the DEA has taken, jointly with SAMHSA,  in temporarily extending flexibilities for the remote prescribing of clinically appropriate controlled substances for six months, through November 11, 2023,” Kyle Zebley, senior vice president, public policy, the ATA, and executive director, ATA Action, stated publicly.

“It is especially important and encouraging that these actions cover access to clinically appropriate prescriptions of controlled substances that patients need for a wide variety of medical circumstances, including for mental health and substance use disorders,” Zebley continued.

There is room for improvement in the future, Zebley added.

“We are hopeful that during this extension period, the DEA will revise the draft rules to address unnecessarily restrictive barriers to equitable and appropriate clinical care, such as mandating in-person visits. The ATA and ATA Action are committed to continuing our work with the Agency and others to help create the most effective and appropriate rules that ensure access to needed treatments,” Zebley said.