DEA Proposes New mHealth Rule for Substance Abuse Treatment

Federal officials have proposed easing restrictions on the use of mHealth in substance abuse programs – but the changes aren’t what everyone has been expecting.

Under a notice of proposed rulemaking published last month in the Federal Register, the US Drug Enforcement Agency would allow registered narcotic treatment programs (NTPs) using “mobile components” to consider those connected health elements as a coincident activity.

“The NTP registrants that operate or wish to operate mobile components (in the state that the registrant is registered in) to dispense narcotic drugs in schedules II-V at a remote location for the purpose of maintenance or detoxification treatment would not be required to obtain a separate registration for a mobile component,” a summary of the rule states.

“This proposed rule would waive the requirement of a separate registration at each principal place of business or professional practice where controlled substances are dispensed for those NTPs with mobile components that fully comply with the requirements of the proposed rule, once finalized,” the summary continues. “These revisions to the regulations are intended to make maintenance or detoxification treatments more widely available, while ensuring that safeguards are in place to reduce the likelihood of diversion.”

The notice is different from what telehealth and mHealth providers have been waiting for: a rule that would ease federal restrictions on the prescription of scheduled drugs via telemedicine, and one that federal officials had been expected to unveil. It even prompted Virginia Sen. Mark Warner to issue a press release congratulating the DEA on making that move.

"The opioid and addiction epidemic has had a devastating impact on communities in Virginia and across the country," Warner, who had sent a letter to the DEA in January, said in a press release that has since been deleted. "We need to use every tool at our disposal to ensure that individuals struggling with addiction can access the treatment they need, and telehealth is an important part of that. I am pleased the DEA has finally issued proposed rulemaking that will improve telehealth access for these patients and I hope they will work quickly to finalize this rulemaking once stakeholders have had an opportunity to weigh in."

With the Special Registration for Telemedicine Act of 2018, which was part of the SUPPORT for Patients and Communities Act signed into law by President Donald Trump in late 2018, the DEA had until October 24, 2019 to set the ground rules for providers with a special registration to prescribe controlled substances.

That deadline passed without action. In November, the Justice Department announced plans to issue a proposed rule to create that registration process. But nothing has happened since then, and the DEA and other federal agencies have refused to give any updates.

Last month’s ruling leaves healthcare providers looking for more leeway in treating substance abuse issues both pleased and disappointed. It’s a step in the right direction for programs using digital health tools, but not the leap forward that so many have been anticipating.