- The HHS on Thursday finalized a rule that will allow opioid treatment programs to begin some medication treatment via telehealth.
- Under the rule, these providers will be able to initiate treatment with buprenorphine through audio-only or audio-visual telehealth. They can begin methadone treatment via an audio-visual platform — but not through an audio-only option due to its higher risk profile, the Substance Abuse and Mental Health Services Administration said.
- The regulation makes permanent telehealth flexibilities that began during the COVID-19 pandemic to preserve access to care and tackle a worsening opioid epidemic.
The rule marks the first substantial changes to treatment and delivery standards at opioid treatment programs in more than 20 years, SAMHSA said.
The updates — which also include expanding eligibility for patients to receive take-home doses of methadone and allowing more provider types to order medications — aim to reduce stigma and expand care access, which can be challenges to treating people with substance use disorders.
Telehealth could be a significant aid on that front, experts say. Virtual care use soared during the COVID pandemic, helped by loosened regulations that allowed patients to receive care while maintaining social distance.
Some research has shown telehealth can expand who can access mental healthcare and opioid use disorder treatment, potentially preventing overdoses. Provisional data suggests drug overdose deaths reached nearly 107,000 during the 12 months ending in August 2023, according to the Centers for Disease Control and Prevention.
“While this rule change will help anyone needing treatment, it will be particularly impactful for those in rural areas or with low income for whom reliable transportation can be a challenge, if not impossible,” Miriam Delphin-Rittmon, the HHS assistant secretary for mental health and substance use, said in a statement.
Regulators have made other changes that could improve access to substance use disorder treatment. During the pandemic, the Drug Enforcement Administration granted exceptions to the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which required most practitioners to have at least one in-person evaluation before prescribing controlled substances.
The DEA and the HHS announced in the fall that they would extend pandemic-era prescribing rules through 2024. Advocates cheered the extension, arguing in-person requirements limited access, particularly for opioid use disorder care.