Washington: The Biden administration moved Friday to require patients to see a doctor in person before receiving drugs for attention deficit disorder or addictive pain relievers, tightening access to drugs in the context of a health crisis. ever deeper opioids.
The proposal could change the way millions of Americans get some prescriptions after three years of relying on telehealth for medical appointments by computer or phone during the pandemic.
The Drug Enforcement Administration (DEA) said late Friday that it plans to reinstate long-standing federal requirements for powerful drugs that didn’t apply once COVID-19 hit. 19, allowing doctors to write millions of prescriptions for drugs like OxyContin or Adderall without meeting the patients in person.
Patients will need to see a doctor in person at least once to get an initial prescription for the drugs the federal government says have the highest potential for abuse: Vicodin, OxyContin, Adderall, and ritalin, For example. Refills can be prescribed at telehealth appointments.
The agency will also clamp down on how doctors can prescribe other, less addictive drugs to patients they have never physically met. Substances such as codeine, which is taken to relieve pain or coughing, Xanax, which is used to treat anxiety, Ambien, a sleeping pill, and buprenorphine, a narcotic used to treat opioid addiction, can be used. prescribe via telehealth for a 30-day initial dose. Patients would need to see a doctor at least once in person to get a refill.
Patients will still be able to get common prescriptions like antibiotics, skin creams, birth control, and prescription insulin through telehealth visits.
The new rule seeks to maintain expanded access to telehealth that is important for patients like those in rural areas while balancing safety, an approach DEA Administrator Anne Milgram referred to as “spreading telemedicine with guardrails.”
The ease with which every American has accessed certain drugs during the pandemic has helped many get needed treatment, but has also raised concerns that some companies could take advantage of lax rules and overprescribe drugs to people who don’t need them. need, said david herzbergdrug historian at the University at Buffalo.
“Both sides of this tension have very good points,” he said. herzberg. “You don’t want barriers in the way of people getting the prescriptions they need. But every time you remove those barriers, it’s also an opportunity for profit seekers to exploit the lax rules and sell the drugs to people who may not want them.” need”.
US overdose deaths hit a record high in 2021, about three-quarters of those caused by opioids during a crisis first sparked by the drugmakers, pharmacies and doctors who pushed the drugs to patients decades ago. But the grim toll of synthetic opioids like fentanyl far exceeded prescription drug-related deaths that year, according to the Centers for Disease Control. Fentanyl is increasingly appearing on the illicit market, compressed into fake prescription pills or mixed with other drugs.
The proposed rules deal a major blow to a booming telehealth industry, with tech startups launching in recent years to treat and prescribe drugs for mental health or attention deficit disorders. The industry has largely benefited from the postponement of in-person medication visits caused by the pandemic, though some national retailers stopped filling drug orders generated by some telehealth apps over the past year.
The DEA has grown increasingly concerned over the past two years that some of those telehealth start-ups are prescribing addictive substances such as opioids or attention-deficit-disorder drugs, endangering patients, an official said. from the DEA to The Associated Press on Friday.
The official said the agency plans to implement the new rule before the COVID-19 public health emergency expires on May 11, which will effectively end the relaxed rules. That could mean people seeking treatment from a doctor hundreds of miles away should start developing plans for in-person visits with their doctors now, the Boston-based attorney said. jeremy sherer, who represents telehealth companies. Patients will have six months to visit their doctor in person when the regulation is enacted.
“Providers and their patients need to know what that treatment will look like going forward and whether, once the public health emergency ends in May, they will need to find a way to have an in-person visit before further treatment, and that may be a real challenge,” he said.
Many states have already moved to restore limitations on telehealth care across state lines. By October, nearly 40 states and Washington, DC, had canceled emergency declarations that made it easier for doctors to see patients in other states.
