The agency has submitted a temporary extension for flexibilities that allow providers to prescribe controlled substances via telehealth without a prior in-person medical exam.

By: Anuja Vaidya

 – After receiving thousands of comments asking for an extension of pandemic-era virtual prescribing flexibilities, the Drug Enforcement Administration has acquiesced.

The flexibilities allow healthcare practitioners to prescribe various controlled substances, including Adderall, via telehealth without a prior in-person medical evaluation.

“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,” the DEA said in a statement.

The agency received nearly 38,000 comments on its proposed rule released in February. Per the proposal, providers would only be allowed to virtually prescribe a 30-day supply of Schedule III-V non-narcotic controlled medications and a 30-day supply of buprenorphine for treating opioid use disorder (OUD) without a prior in-person examination. This flexibility was not extended to other controlled substances, like Adderall, Oxycodone, Vicodin, and Ritalin, in the proposed rule.

The healthcare industry criticized the proposal, with several prominent trade associations, mental healthcare organizations, and providers voicing concerns.

“There is an ever-increasing number of patients who cannot or will not seek treatment for their conditions in person,” said Kyle Zebley, executive director of ATA Action, the advocacy arm of the American Telemedicine Association, in a letter to the DEA. “These are the patients who will fall through the cracks under this rule, creating a significant and avoidable public health crisis.”

Another letter that includes numerous signatories, such as the American Psychiatric Association, Mental Health America, the Medical University of South Carolina, and Stanford Health Care, noted the burgeoning mental health crisis in America and how the rule could curb much-needed healthcare access.

“Recognizing the ongoing national need for more behavioral health access, the undersigned organizations request that the DEA make modifications to the proposed rule to ensure more flexible prescribing limitations for providers when a controlled substance is offered by a highly trained clinician in conjunction with an ongoing mental health treatment plan,” the letter stated.

Considering these comments, the DEA and the Department of Health and Human Services submitted a draft temporary rule to the Office of Management and Budget that provides a temporary extension of telehealth flexibilities for controlled substance prescriptions. Details about the rule will become public after it is published in the Federal Register.