Feds ease restrictions on treating opioid addiction via telehealth

The expanded use of telehealth for combatting opioid addiction is part of a recent update to U.S. Department of Health and Human Services (HHS) regulations governing opioid treatment programs (OTPs) to expand access to methadone, buprenorphine and other medications used to treat opioid addiction. The update, the first in 20 years, is contained in a recent rule issued by the Substance Abuse and Mental Health Services Administration (SAMHSA), which is part of HHS.

“This final rule represents a historic modernization of OTP regulations to help connect more Americans with effective treatment for opioid use disorders,” Miriam E. Delphin-Rittmon, Ph.D., HHS assistant secretary for mental health and substance use and head of SAMHSA, said in a news release. She added that the rule change will be especially helpful to people living in rural areas or with low income, many of whom face difficulties getting to a doctor’s office.

Provisions of the rule designed to increase access to medications for treating opioid use disorder include the following:

Making permanent the flexibilities introduced during the COVID-19 pandemic that expand eligibility for patients to receive take-home doses of methadone. Research has shown that patients receiving take-home doses are more likely to remain in treatment and less likely to use illicit opioids.

Allowing use of telehealth to start treatment for opioid addiction, including methadone via audio-visual telehealth technology and buprenorphine via audio-only technology.

Allowing nurse practitioners and physician assistants to order medications in OTPs, where state law allows, to reduce the burden on OTP operations and increase patient access to medications.

Removing the requirement that patients have a history of addiction for a full year before being eligible for treatment.

Expanding access to interim treatment, allowing patients to initiate medication treatment while awaiting further services to ensure people have access to care as soon as they are ready.

The American Medical Association praised the increased access to methadone treatment for patients starting or continuing in an OTP. “Cementing these policies is a step in the right direction in the fight against the worsening overdose epidemic to increase equitable access to care, reduce stigma of seeking treatment for OUD and embrace technology in medicine,” Bobby Mukkamala, M.D., chair of the association’s Substance Use and Pain Care Task Force, said in a statement. “Modernizing rules and regulations for prescribing these medications continues to be of paramount importance.”

The final rule becomes effective on April 2 with a compliance date of Oct. 2, 2024.

Jeffrey Bendix is senior editor of Medical Economics.