In February 2024, the U.S. Department of Health and Human Services (HHS) finalized a rule that will allow opioid use disorder (OUD) treatment via telehealth. The rule finalizes substantial changes to treatment and delivery standards for opioid treatment programs and allows providers to:
- Initiate treatment using buprenorphine through audio-only or audio-visual telehealth visits.
- Initiate methadone treatment through audio-visual visits. The Substance Abuse and Mental Health Services Administration (SAMHSA) has stated that an audio-only telehealth visit is not an option for methadone due to its higher risk profile.
The regulation adopts the telehealth flexibilities that began during the COVID-19 pandemic. The telehealth flexibilities are now a permanent tool to help preserve access to care needed to combat the national opioid crisis.
The new telehealth flexibilities also include:
- Expanded eligibility for patients to receive take-home doses of methadone and other medication-assisted treatment (MAT) medications. Previously, the administration of methadone was required to occur in certain settings that did not include the patient’s home.
- Expanded eligible provider types who can prescribe medications. Physicians and nurse practitioners can now initiate MAT.
The goal of the telehealth flexibilities is to help reduce patient stigma and expand access to care, two significant challenges to treating people with OUD. The expansion of access to mental health care and treatments for OUD potentially prevents overdoses and deaths and aids those challenged in rural areas and or low income without reliable transportation to access treatment.
Along with the new telehealth flexibilities, which went into effect on April 1, 2024, the Drug Enforcement Administration (DEA) and HHS announced they would extend pandemic-era prescribing rules through 2024. This continuation includes 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. Advocates for the extension cheered this decision as in-person requirements limit patient access, particularly for OUD treatment.
Reference Links:
Federal Register_02022024_Medications for the Treatment of Opioid Use Disorder