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Prescriptions written via telehealth are subject to new restrictions announced by the United States Drug Enforcement Administration (DEA).

Driven by the pandemic, telehealth services have become mainstream. Many medical practitioners offer remote medical care, which has proved timely and essential for those in rural health and other settings. The rapid advancement of remote medical care occurred by necessity—oftentimes without federal or state rulemaking.

The DEA recently announced new regulations around telehealth visits, specifically those conducted to prescribe certain medications.  Until now, a medical provider could prescribe a controlled substance without seeing the patient in person. The US continues to be severely impacted by the opioid epidemic. Statistics show 224,935 people died of preventable overdose in 2021, an all-time high. As the opioid epidemic worsens, the DEA proposed new rules. 

The new rule impacts primarily those who prescribe controlled substances.  Of those, the rules affect practitioners who prescribe these drugs without having ever assessed their patient in person.  The DEA is aiming at Schedule II, Schedule III, Schedule IV, and Schedule V drugs, including Lyrica, Xanax, Ambien, Valium Buprenorphone, Vicodan, Oxycodone, and others.

For telehealth providers who prescribe controlled medications named under the rule who have not assessed their patient in person, the new rules allow the prescription of a 30-day supply of Schedule III non-narcotic controlled drugs.  A 30-day supply of buprenorphine used for treating opioid disorder is allowed as well.

Drugs like antibiotics, cholesterol-lowering medications, blood pressure, insulin, and birth control medications are not subject to the in-person rule. As noted by the DEA, “The permanent expansion of telemedicine flexibilities would continue greater access to care for patients across the country, while ensuring the safety of patients. DEA is committed to the expansion of telemedicine with guardrails that prevent the online overprescribing of controlled medications that can cause harm.”

For those who are not able to see their telehealth provider in person, the provider can refer the patient to another practitioner who will be able to see the patient in person.  The patient can then be referred back to the original referring provider.  The rule requires one in-person appointment between patient and provider, the appointment does not have to be repeated. That said, individual state laws may dictate additional prescription practices for opioid medications.

The new rules create guardrails for telehealth providers and their patients. Given the death toll to opioids in this country, these new rules are too late for those who have already lost their lives to an overdose.

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