DEA Urged to Implement Telemedicine Special Registration for Prescribing Controlled Substances

Eighty organizations, led by the Alliance for Connected Care, are calling on the U.S. Drug Enforcement Administration (DEA) to implement a telemedicine special registration process that would enable providers to safely prescribe controlled substances remotely.

In an Oct. 26 letter to the DEA, the organizations said that their experience during COVID-19 has demonstrated the value of increased access to telemedicine to enable all qualified providers, including Community Mental Health Centers and addiction treatment facilities, to prescribe Medication Assisted Treatment (MAT) to patients with Opioid Use Disorder (OUD).

They called the lack of a registry to allow for providers of telemedicine services to prescribe “a failure of the bureaucracy.”

The advocates noted that in October 2018, President Trump signed into law the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. This legislation required the Attorney General, in consultation with the Secretary of Health and Human Services, to announce regulations specifying the circumstances for a special registration for telemedicine.  

“It has been a full two years since adoption of the SUPPORT Act and no meaningful progress has been made to further the execution of this critical policy,” the letter states.

Since the outset of the COVID-19 epidemic, the DEA, in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA), decided to allow remote prescribing of controlled substances using telemedicine without a prior in-person exam, regardless of the patient’s location.

While applauding this action, the letter noted that such an emergency action is only required because the DEA and other federal agencies have failed to execute the requirements of the SUPPORT Act.  

The letter describes how the opioid crisis has taken a turn for the worse during the pandemic. “More than 40 states  have recorded increases in opioid-related deaths since the pandemic began. In Arkansas, the use of Narcan, an overdose reversing medication, has tripled. Officials in Jacksonville, FL have seen a 40 percent increase in overdose related emergency calls. In March alone, York County, PA recorded three times as many overdoses as usual. The nationwide data is similarly alarming: drug overdoses increased 18 percent in March compared with last year, 29 percent in April, and 42 percent in May according to the Overdose Detection Mapping Application Program (ODMAP), a federal initiative that collects data from ambulance teams, hospitals, and police.”

Given the worsening opioid overdose crisis, the 80 stakeholder organizations urge the DEA to move forward with the telemedicine special registration process required by federal law that will enable SAMHSA waivered clinicians, Community Mental Health Centers and addiction treatment facilities to prescribe MAT to patients with OUD via telemedicine technology.