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Opioid addiction doctors want telehealth rules to stay relaxed

Opioid addiction doctors want telehealth rules to stay relaxed


Under pandemic-era rules, they’re able to prescribe medications for opioid-use disorder via telehealth. That’s increasing access to treatment.

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Bottle of prescription drug buprenorphine
Buprenorphine can help people with opioid-use disorder.
Photo illustration by Joe Raedle/Getty Images

Doctors treating patients with opioid-use disorder want pandemic-era telehealth rules to stay relaxed, according to a new survey. Tens of thousands of people in the United States die each year from opioid overdoses, and telehealth makes it easier to connect people who are at risk of overdose with treatments.

“Continued flexibility would allow more individuals to access life-saving treatment,” study author Tamara Beetham, who studies health policy and management at the Yale School of Public Health, said in a statement.

Before 2020, doctors could only prescribe controlled substances after an in-person visit with a patient. Controlled substances include medications like Xanax and Adderall, but they also include buprenorphine and methadone, which are used to treat opioid-use disorder. But once the covid pandemic was declared a public health emergency, the rules loosened and allowed physicians to prescribe those drugs after telehealth visits.

Researchers at the Yale School of Public Health surveyed over 1,000 doctors who prescribe buprenorphine. Less than one-third had used telehealth for buprenorphine treatment before the pandemic. Once covid started to take hold, that number jumped. In the early days of covid-driven telehealth programs, two-thirds said they’d used it. Addiction specialists were most likely to say they used telehealth for buprenorphine treatment.

Right now, the relaxed rules around controlled substance prescriptions are temporary. Eventually, the federal government will end the federal public health emergency. (It was just renewed last week for another 90 days.) At that point, policies would revert back to the way they were before. Doctors wouldn’t be able to start people on buprenorphine over video or phone visits.

The survey found that the vast majority of doctors who prescribe buprenorphine want the changes to become permanent: 85 percent were in favor and 68 percent were strongly in favor. The new landscape has helped improve access to highly effective treatments for opioid-use disorder and has likely saved lives. One study found that the expansion of telehealth reduced the odds of overdose among people on Medicaid.

Some lawmakers have introduced bills that would let doctors keep distributing medication for opioid-use disorder over telehealth even after the end of the public health emergency. It’s possible the rules, and their benefits, could stick around. But some experts worry that drugs for opioid-use disorder will get caught up in backlash against telehealth prescriptions for other controlled substances, like Adderall. A handful of startup companies started distributing ADHD medications over telemedicine during the pandemic, and some are now under investigation by federal agencies over their practices.

“It’s very easy for these things to kind of get grouped together in people’s minds and then also in policy,” Shoshana Aronowitz, a health services researcher at the University of Pennsylvania who provides substance-use disorder treatment, told The Verge in August.