COVID-19 changed our world.
But some of these changes were moving in the right direction.
For example, getting help for substance abuse problems, including opioids, has evolved. As telehealth expanded and became more critical, it allowed people suffering from addiction to get treatment. Some of these treatments include potentially life-saving medications, such as buprenorphine (Suboxone), in their own home, an environment where they feel safe and less prone to being judged.
With covid-related health measures set to expire, so will doctors and treatment professionals’ ability to treat those suffering from addiction via telehealth. This includes medication-assisted treatment (MAT), a helpful tool for those suffering from addiction to certain substances of abuse, such as opioids.
A Novel E-Approach to Treatment
When COVID-19 became a national crisis in March 2020, it sent the country inside and scrambling. Suddenly, we had to figure out how to live life without leaving the house. Communication via teleconference became the norm, and everyone was learning what zoom was and how to use it, including doctors and treatment professionals.
Since they couldn’t have their practices and facilities open for patients to see them, they had to get creative and see and treat patients via video calls.
The government implemented new federal regulations for patients needing to get their medications. These regulations allowed doctors and treatment professionals to issue these prescriptions during an audio or video appointment, even if they were no longer in the same city or state as the prescribing doctor.
With these Covid-related federal regulations expected to expire in the next few months, so will doctors and treatment professionals’ ability to prescribe medications to patients without being in person.
Why the DEA Wants to End Telehealth for Addiction
The Drug Enforcement Agency (DEA) regulates all controlled substances at a federal level. While the agency came out in March and said they were working to make the pandemic regulations that allowed people to receive treatment via video or phone call, there have been no changes.
The DEA has made promises relating to telehealth. In 2009 the DEA pledged to expand telehealth access for controlled substances, but they did nothing. The inaction of the DEA has led to tension between the DEA and other federal agencies, such as the Substance Abuse and Mental health Services Administration (SAMHSA).
“There’s this tension between the federal agencies, where you’ve got SAMHSA and the [Office of National Drug Control Policy] saying medications for opioid-use disorder are good,” Corey Davis, director of the Harm Reduction Legal Project recently told Politico. “And then you’ve got the DEA, which it’s just in its DNA to try and control controlled substances.”
One of the concerns on the side of the DEA is that these controlled substances used for MAT, buprenorphine, could be sold illegally. However, studies have shown though that this is unlikely.
A National Institute on Drug Abuse (NIDA) study showed that between 2015 and 2019, buprenorphine misuse declined significantly, and in 2019 only about a quarter of all patients taking the drug as part of MAT reported misusing it.
Another potential issue is accessibility.
Some argue that while there is fear that easier access will result in more drug abuse, there is also the concern that if telehealth becomes more common, it could disproportionately affect those who don’t have access to high-speed internet.
How Will This Affect Addiction Recovery?
Since March of 2020, when Covid-19 became an official pandemic in the United States, drug addiction and overdose have become more prevalent. In fact, According to the Centers for Disease Control and Prevention, more Americans now die from drug overdose than guns or suicide, with over 100,000 people dying from a drug overdose just in 2021 alone.
While those numbers are incredibly high, many in the addiction and treatment world have argued that if it weren’t for the expanded access to telehealth during the pandemic, those numbers would have been even higher, especially regarding opioid abuse and addiction. The argument was that with people able to seek treatment in their own home, it not only eliminated many of the stigmas associated with addiction and treatment, but more people were continuing to get help for extended periods.
While the DEA and the federal government have been dragging their feet regarding making MAT available via telehealth a permanent thing, some states have started taking measures into their own hands.
In Vermont, the state legislature passed a law this year allowing MAT to continue via telehealth through 2023. In Alabama, a new law requires a doctor prescribing controlled substances to have seen the patient in person at least once within the past 12 months. The varying state rules have caused headaches for health professionals, especially since COVID-19 has resulted in some of their patients moving away.
“The need for sweeping, consistent federal guidelines is critical to make sense of the patchwork of local and state regulations that are outdated, contradictory, and often written before telemedicine existed,” Stephanie Strong, founder and CEO of Boulder Care, a telehealth addiction treatment program, told Politico earlier this month.
While many treatment centers have begun putting contingency plans in place should the ability to treat patients via telehealth end, many fear that it could result in people either not seeking treatment or ending their treatment early.
If you are looking for addiction treatment, whether in person or in telehealth, call the SAMHSA helpline at 1-800-662-4357 or visit their online program locator to find addiction treatment options in your area.