DEA temporarily extends telehealth prescribing flexibility for controlled substances

Key takeaways:

• The U.S. Drug Enforcement Agency’s extension comes after two proposals to restrict telehealth prescribing for controlled substances.
• The proposals received a record 38,000 comments.

The U.S. Drug Enforcement Agency, or DEA, has announced a temporary extension of prescribing flexibility for controlled substances over telehealth, which was set to expire on May 11.

The prescribing flexibilities have been extended to Nov. 11, 2023.

“We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities while we work to find a way forward to give Americans that access with appropriate safeguards,” DEA Administrator Anne Milgram said in a press release.

Prior to the COVID-19 pandemic, controlled substances could only be prescribed virtually if an in-person visit had previously been conducted. That protocol was waived in March 2020 to increase accessibility.

The DEA proposed two rules this past March which would have again required an in-person examination before controlled substance could be prescribed over telehealth, limiting access to prescribed Schedule III to V non-narcotics and buprenorphine for opioid use disorder.

According to Milgram, the proposals received a record 38,000 comments from the public.

“We take those comments seriously and are considering them carefully,” she said.

Speaking to Healio, Kyle Zebley, the senior vice president of public policy at the American Telemedicine Association (ATA) and executive director of the organization’s advocacy arm, ATA Action, said that while it is unlikely the COVID-19 protocols for flexible prescribing will last indefinitely, “the fact the DEA is asking for more time to finalize the rules impacting remote prescribing of controlled substances leads telehealth advocates to be hopeful that the rules could be improved and look (hopefully) more akin to the [public health emergency]-era status quo.”

Further details about the temporary rule will become public after its full publication in the Federal Register, Milgram said.

Editor’s note: This story has been updated to include the new expiration date for the prescribing flexibilities

References:

• ATA and ATA Action respond to DEA’s extension of COVID-19 telemedicine flexibilities for remote prescribing of controlled substances. https://www.americantelemed.org/press-releases/dea-ruling-extension/. Published May 4, 2023. Accessed May 4, 2023.
• Expansion of induction of buprenorphine via telemedicine encounter. https://www.federalregister.gov/documents/2023/03/01/2023-04217/expansion-of-induction-of-buprenorphine-via-telemedicine-encounter. Accessed May 4, 2023.
• Statement from the DEA Administrator Anne Milgram on COVID-19 telemedicine flexibilities for prescription of controlled medications. https://www.dea.gov/documents/2023/2023-05/2023-05-03/statement-dea-administrator-anne-milgram-covid-19-telemedicine. Published May 3, 2023. Accessed May 4, 2023.
• Telemedicine prescribing of controlled substances when the practitioner and the patient have not had a prior in-person medical evaluation. https://www.federalregister.gov/documents/2023/03/01/2023-04248/telemedicine-prescribing-of-controlled-substances-when-the-practitioner-and-the-patient-have-not-had. Accessed May 4, 2023.