By now, I think we can all agree that virtual doctor’s appointments are very convenient. At Shanti Wellness and Recovery, our patients love the convenience of being able to access cutting edge, evidence based addiction treatment via telemedicine.
It wasn’t always this easy to seek care for Substance Use Disorder (SUD) in general or Opioid Use Disorder (OUD) in particular. In fact, before the pandemic, telemedicine prescribing for life saving medications like buprenorphine was not allowed. As shutdowns began, the addiction treatment community scrambled to maintain continuity of care for MAT patients, making it easier to access medication than ever before.
Now, the Drug Enforcement Administration is considering reversing pandemic era regulations and instituting a federal ban on telemedicine prescribing for opioids and stimulants, including lifesaving addiction treatment medications like buprenorphine.
Today, we’ll consider the pros and cons of reversing these rules and look at what the evidence says about telehealth and Substance Use Disorder patients.
Prescribing Rules for Life Saving Addiction Treatment Medication are Governed by Specific Federal and State Laws
In the past, federal law required an in-person visit to a doctor’s office in order to complete a physical evaluation before buprenorphine could be prescribed. The pandemic changed those federal rules on a temporary basis, making it possible for some physicians to prescribe this life-saving medication via telemedicine instead. However, this change was initiated on a state-by-state basis, as doctors must not only follow federal but also state law. Not all states allow for the initiation of buprenorphine treatment via telehealth.
The DEA Hopes to Restrict Telemedicine Access to Burprenorphine and Other Life Saving Medications
The Drug Enforcement Administration (DEA) in the United States is gearing up to reverse federal pandemic-era telemedicine rules that made it easier to prescribe buprenorphine via telemedicine. While the DEA’s proposed rule change will still allow for some telemedicine access to buprenorphine, it will require all patients to visit a physician’s office in person in order to continue with the medicine after an initial 30 day introductory period. This proposed rule change would also affect opioids and stimulants for all patients – including those seeking treatment for conditions like chronic pain and ADHD.
DEA Proposes Buprenorphine Rule Change Despite Overall Reduction in Fatal Overdose Risk
The DEA’s proposed rule change for telemedicine access for buprenorphine might appear to be motivated by patient safety, but there’s evidence that the policy doesn’t actually support positive outcomes for addiction treatment patients. In fact, one study found that patients who receive telehealth treatment for Opioid Use Disorder actually enjoy a 33% reduction in fatal overdose compared with patients who don’t receive such services.
Access to Addiction Treatment Medication is Especially Important for Rural Americans
The ability to access MAT in general and buprenorphine in particular via telemedicine is an especially pertinent issue for rural American health care systems. 90% of rural counties in the United States don’t have enough opioid treatment services available to meet resident demand. Many of these counties have no services available at all. This is a huge barrier to treatment for many rural Americans. The combination of lengthy travel times, limited access to transportation and high rates of poverty mean that regular health care related trips are not possible for many rural residents who may suffer from SUD and would otherwise benefit from treatment.
Patients Who Are Prescribed Buprenorphine via Telemedicine are More Likely to Stay in Treatment Longer-Term
In order to be effective, addiction treatment needs to be relatively easy to access on an ongoing, long-term basis. One study found that OUD patients who are offered buprenorphine in a telemedicine setting are more likely than others to stay in treatment long-term. This study found that over 56% of patients offered such a treatment remained under physician care for six months, while over 48% stayed for twelve months. This is a powerful retention rate that cannot be achieved through other delivery methods.
Addiction Treatment Doctors Overwhelmingly Support Making Temporary Telehealth Rules for Addiction Treatment Medicine Permanent
According to US News, over 85% of physicians who treat OUD support the continuation of more relaxed rules for telemedicine prescribing when it comes to addiction treatment in general and Opioid Use Disorder treatment in particular. This is a strong piece of evidence in favor of halting the proposed DEA rule change, as physicians are in a position to understand the pros and cons of reducing barriers to MAT medications like buprenorphine.
Looking for MAT, Buprenorphine for Addiction Treatment or Opioid Use Disorder Treatment in Portland Oregon?
At Shanti Recovery and Wellness, we understand how difficult it can be to seek treatment for SUD. We are committed to reducing barriers to treatment for addiction treatment patients in Portland, Oregon and beyond.
Interested to learn more about how we can help? Give us a call today to begin your journey to freedom from addiction.