Of Counsel Emily Wein and associate Sunny Levine were cited in the mHealth Intelligence article, “DEA Gives Providers Leeway to Use Telehealth for Substance Abuse Care.” The article discusses how the U.S. Drug Enforcement Agency has waived provisions of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 amid the COVID-19 pandemic and relaxed requirements that allow providers more freedom to use digital health to treat patients.
On March 4, the DEA issued a notice of proposed rulemaking that allows registered narcotic treatment programs (NTPs) to use “mobile components … to dispose 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.”
The DEA’s action of March 16, which clarified the public health emergency exemption, made that more clear.
More recently, according to Foley’s Health Care Law Today blog, in a post written by Levine and Wein, the DEA has taken further steps to promote virtual care for opioid use disorder (OUD) treatment.
On March 19, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued guidance allowing Opioid Treatment Programs and certified care providers to use prescribed drugs and conduct treatments over the phone without first meeting in person. Shortly thereafter, Levine and Wein wrote, the DEA joined SAMHSA in issuing a letter allowing “’authorized practitioners’ to prescribe buprenorphine to new and existing OUD patients for maintenance or detoxification treatment on the basis of telehealth examination, which may include a telephone voice-only evaluation - without the need for a prior in-person exam.”
“The DEA Letter allows authorized practitioners the added flexibility of using audio-only modalities (i.e., telephone) - instead of audio-visual, real-time, two-way interactive communication system - which is required to prescribe controlled substances via telemedicine, pursuant to the aforementioned emergency exception to the federal Ryan Haight Act,” Levine and Wein said.
Authorized practitioners are defined as OTP providers, which are registered with the DEA, and care providers who have received a waiver from SAMHSA to prescribe or dispense buprenorphine for OUD treatment in a non-OTP setting.
Finally, Levine and Wein point out that each state has its own telehealth laws – some banning the use of telehealth to prescribe controlled substances – and many have issued emergency directives regarding the use of telehealth during the pandemic. So it’s up to the care provider to research all relevant federal and state laws before taking advantage of the DEA and SAMHSA guidance.