Background on DEA Telemedicine Changes
During the height of the COVID-19 crisis, the Drug Enforcement Agency (DEA) made the groundbreaking decision to relax its traditionally rigorous guidelines concerning the teleprescription of controlled substances, requiring only an initial in-person meeting1. This move was in response to decades of controversy about the DEA telemedicine policy, initiated by the Ryan Haight Act, given the need to ensure continued patient care during unprecedented times.
Current DEA Telemedicine Adjustments
In a recent pronouncement, the DEA has permitted healthcare providers to employ DEA Telemedicine further to prescribe particular controlled substances until December 31, 20242. The primary intent behind this extension is to ensure a seamless transition for the numerous patients and clinicians who have become dependent on DEA Telemedicine for their controlled medication prescriptions.
Controlled Substances Under DEA Telemedicine
Controlled substances under this rule include medications for attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, and opioid use disorder. The pressing need for prescription privileges is apparent in cases involving ADHD, for example, which is gaining national attention, given the nationwide Adderall shortage. It is estimated that six million children and their families currently struggle with the condition in the US.
The inability of families to access Adderall or safe alternatives points to potential negative repercussions on future generations as the lack of adequate intervention can impede children’s ability to learn and retain information and attend class at a time when classroom re-integration after COVID still poses challenges for teachers and school districts. The DEA’s decision moving forward for this single condition alone can significantly impact the overall academic performance of all children involved.
These emerging issues make telemedicine increasingly imperative, pressuring groups such as the American Medical Association as the DEA Telemedicine approach facilitates a broader reach for essential treatments for these conditions. The DEA has been cautious, particularly given the broadscale failures of companies such as Cerebral and Done Global, who have gotten into hot water for offering Adderall through telemedicine in the past.
The Path Forward: Responses and Reactions
However, the DEA’s recent decision has not been without its dissenters. Despite statements from organizations like the American Telemedicine Association, which commends the DEA’s measured and comprehensive approach to formulating the correct regulations, or the DEA’s recent listening session to hear stakeholder opinions, the Health Innovation Alliance offers a contrasting view3. They assert that the DEA Telemedicine flexibilities, while beneficial, are still too transient. They urge the DEA to acknowledge the success of e-prescribing and to authorize it to move forward fully.
Furthermore, in a recently convened listening session, many stakeholders from various domains, including patients, medical professionals, and industry associations, encouraged the DEA to permanently extend these guidelines and consider introducing a unique registration procedure for remote prescribing under DEA Telemedicine4.
It’s worth noting that legislative figures, such as Sens. Mark Warner (D-Va.), John Thune (R-S.D.), Catherine Cortez Masto (D-Nev.), and Shelley Moore Capito (R-W.Va.), have voiced their concerns. They highlight that the DEA Telemedicine proposal from February might curtail clinicians’ abilities to prescribe controlled substances without a physical consultation5.
Future Directions for DEA Telemedicine
Looking ahead, while the