Pennsylvania provider tells DEA how telemedicine combats opioid crisis

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(The Center Square) – Though some have concerns, health care experts want to see the Drug Enforcement Administration preserve the pandemic-era expansion of telemedicine to address the opioid crisis.

The Drug Enforcement Administration this week held a listening session for its telemedicine rules, and one Pennsylvania addiction treatment provider encouraged the federal agency to make its temporary rules permanent.

“Telehealth really helped us to improve our retention and treatment,” Philip Moore, chief medical officer of Gaudenzia, said.

Gaudenzia provides addiction treatment and recovery services across Pennsylvania, Delaware, Maryland, and Washington D.C, and Moore estimated they served more than 15,000 people last year.

“Our endorsement is rooted in a belief that vital substance use disorder treatment – including medication assisted treatment – should be available for all those who seek it and when they seek it.”

In May, DEA and the Substance Abuse and Mental Health Services Administration issued a six-month extension of COVID-era rules that allowed doctors to prescribe some controlled substances without an in-person evaluation, as The Center Square previously reported.

“DEA recognizes the importance of telemedicine in providing Americans with access to needed medications, and DEA has been, and remains, committed to expanding access to telemedicine in a way that puts patients – and their safety – first,” the agency noted when announcing the listening session in August.

Moore said in his comments that telemedicine’s use during the pandemic showed major benefits for people with a drug addiction. Gaudenzia developed telehealth programs where patients could come in for counseling and drug screenings, and also get medications like buprenorphine to treat drug addiction.

“We were able to create a rotating schedule where a prescriber rotated around between multiple sites and we offered telemedicine,” Moore said. “What our program allowed us to do was to bridge (medication assisted treatment) and mental health treatment until our patients could transition from our residential facilities to community providers, or would allow us to really maximize who we could see at our rural locations.”

The flexibility to use telemedicine, Moore said, reduced barriers for patients in rural areas. If federal approval of remote medicine ends, he worried that the consequences would be dire.

“Removing this much-needed, flexible tool could have significant negative effects on the opioid and addiction epidemic,” he said.

Moore also supported more training and guidelines for telemedicine, as well as improving patient verification and monitoring protocols.

Other health care workers were concerned about diversion, where prescribed medications end up in the hands of other people.

“As a provider, it has been a challenge to make sure that these clients stay in compliance,” said Felicia Bailey, a nurse practitioner with Avaesen Healthcare in Frederick, Maryland.

She suggested the DEA should have more access to clinical documentation such as screenings from other providers to limit abuse of the system.

Roxanne Tyroch of the Texas Medical Association cautioned the DEA against dropping “safeguards” that limit the diversion of medications.

“Now that the pandemic no longer poses these risks, there is little valid justification to extend this relaxing of safeguards against diversion and health-related concerns,” Tyroch said.

Others, though, saw those safeguards as doing little to prevent diversion while creating more barriers to care.

“We are deeply concerned about the DEA’s refusal to implement a special registration process for telemedicine prescribing of controlled substances,” said Caitlin Gillooley, director of quality and behavioral health policy at the American Hospital Association.

The AHA opposes DEA’s proposed rules in March on telemedicine providers, which “would impose burdensome restrictions and administrative requirements … (and) will adversely impact access to medically necessary treatments.”

The emphasis on diversion is also overblown, Gillooley said.

“Practitioners who prescribe controlled substances already keep detailed medical records; these additional record-keeping requirements would not provide further protections,” she said.

On the state level, Pennsylvania recently launched its overdose prevention program to improve training and coordination among agencies. Gov. Josh Shapiro also participated in events recognizing national recovery month, drawing attention to Pennsylvania’s more than 5,000 overdose deaths in 2021.

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