Senators Join Calls for Continued Virtual Access to Controlled Substances

US Sens. Rob Portman (R-OH) and Sheldon Whitehouse (D-RI) sent a letter to the U.S. Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS) urging continued access to controlled substances via telehealth following the COVID-19 pandemic.

During the COVID-19 pandemic, telehealth has proved popular for the delivery of behavioral health services and medication-assisted therapies (MAT). Virtual substance use disorder treatment was made possible during the pandemic by the temporary termination of the Ryan Haight Act, which stated that the prescription of controlled substances requires an in-person examination.

“Emerging research shows that the use of telehealth to prescribe buprenorphine during the pandemic, as permitted under this waiver, increased access to substance use treatment.  We have heard from countless substance use providers in our home states who describe this waiver as a ‘game changer’ in expanding access to treatment for individuals with substance use disorder and combatting the current surge of drug overdoses,” the senators said in the press release.

Portman and Whitehouse's work on this issue began in June 2020 when they introduced the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act, which supports substance use disorder treatment through telehealth by proposing that key regulatory waivers enacted during the pandemic be made permanent.  

The TREATS Act was reintroduced in the Senate in 2021 and was then referred to the Committee on Health, Education, Labor, and Pensions.

While their bill is working its way through Congress, Portman and Whitehouse composed the letter to DEA Administer Anne Milgram and HHS Secretary Xavier Becerra. In it, they expressed a desire for telehealth to become part of the new normal in substance use disorder treatment and requested that the federal agencies permanently waive the Ryan Haight Act in-person examination requirement.

Portman and Whitehouse also referenced research regarding the benefits that telehealth provides, such as the removal of barriers and increased treatment for substance use disorder.

This letter follows a similar one composed by 72 organizations, including the American Telemedicine Association and the American Psychiatric Association. The organizations sent a letter to the same government agencies requesting continued access to telehealth-initiated prescriptions for controlled substances following the COVID-19 pandemic.

Some telehealth waivers have already been extended. The omnibus spending bill, passed last month, has extended telehealth waivers for Medicare beneficiaries for a period of five months following the COVID-19 pandemic. This legislation omits the requirement for an initial in-person visit before receiving mental health virtually but did not include a waiver for the Ryan Haight Act.

Extended coverage and removal of restrictions resulted in an increase in telehealth use among Medicare beneficiaries, according to a June 2021 brief by the Kaiser Family Foundation.