State AGs Urge Continued Virtual Care Access for Opioid Use Disorder Treatment

Led by Attorney General Josh Stein of North Carolina and Attorney General Ashley Moody of Florida, a group of 45 attorneys is urging the Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) to allow providers to continue virtually prescribing buprenorphine for opioid use disorder indefinitely.

The prevalence of opioid use disorders has grown significantly in recent years, affecting varied populations and resulting in high numbers of overdoses. According to the Centers for Disease Control and Prevention (CDC), over 564,000 people died from opioid-related overdose between 1999 and 2020.

The request to the DEA and the SAMHSA aims to expand the treatment offerings for opioid use disorder, specifically by allowing providers to prescribe buprenorphine through telehealth permanently.

"We join a chorus of advocates, addiction treatment providers, medical practitioners, recovery groups, public health experts, and members of the House of Representative’s Bipartisan Addiction and Mental Health Task Force in urging the administration to permanently extend these telehealth flexibilities for buprenorphine," the letter states. 

Approved by the Food and Drug Administration, buprenorphine is a medication used to treat opioid use disorder. The letter further notes that the expiration of virtual prescription capabilities would cut off about 2.5 million US adults from obtaining buprenorphine for this condition.

“The opioid crisis is ravaging communities in every state in this country, and people who are sick with opioid use disorder need access to treatment services,” said Attorney General Josh Stein in the press release. “Too many of our fellow Americans, particularly those in rural areas, are struggling without the medical care they need. The federal government made the right move by allowing doctors to prescribe opioid treatments virtually – but that move needs to be made permanent. I’m pleased to co-lead this bipartisan coalition of attorneys general asking our government to do the right thing.”

The letter also emphasizes the previous success associated with virtual care for opioid use disorder. In March 2020, the DEA allowed providers to prescribe Schedule II-V controlled substances, including buprenorphine, through telehealth. This allowed more patients to receive treatment as it helped eliminate the struggles many face when traveling long distances for in-person care.

“Telehealth has been a powerful tool in allowing us to improve access to life-saving addiction treatment across North Carolina, especially in rural and underserved areas,” said Robyn Jordan, MD, PhD, director of the NC Substance Treatment And Recovery Network and the UNC Addiction Program and associate professor at the University of North Carolina, in the press release. “Many of our patients live in extreme circumstances, often without housing or transportation. Many would have no access to addiction treatment without telehealth. As an addiction treatment professional, I join those urging the federal government to preserve this essential service.”

Similarly, 72 organizations sent a letter to government agencies in March asking for continued access to controlled substances through telehealth, free of initial in-person visit requirements.

At the start of the COVID-19 pandemic, the DEA and the Department of Health and Human Services (HHS) withdrew the requirement for an initial in-person visit before a provider can prescribe controlled substances through telehealth. After determining that the elimination of the requirement led to increased outreach, the organizations composed the letter, which urged the agencies to allow for indefinite access to controlled substances through telehealth.