People suffering from opioid-use disorder might soon no longer have access to at-home treatment and prescription services once a legal deadline runs out. For those seeking treatment, at-home tele-health and prescription services have helped gain access to life-saving drugs from the safety of home while avoiding the stigma of addiction.
Politico first reported the Drug Enforcement Agency has previously missed deadlines for extending virtual access to buprenorphine. Now some health care professionals fear the agency could run out the clock on instituting easy access. The drug, which is taken as a way to reduce dependence on heroin or methadone, is often prescribed to treat opioid addiction. The DEA’s hesitancy toward online-based prescriptions comes despite officials from the Substance Abuse and Mental Health Services Administration telling reporters that tele-health for medication-assisted treatment “has been very effective in connecting people to care… [and] also helping them stay there.”
A bare 11% of those suffering from opioid-use disorder got medication to treat their addiction, according to SAMSHSA. Part of the issue is general access to the drug, but in many cases, patients are often afraid of the stigma associated with their addiction and as a result, they avoid in-person help.
The DEA reportedly promised to permanently stamp access to tele-health into law, but the agency has already missed multiple congressional deadlines in 2018 and 2019, according to Politico. Their apparent hold-up is the fear that buprenorphine could be sold on the streets. The federal regulations instituted in 2020 that allowed health care professionals to prescribe buprenorphine online are set to expire later this year alongside the public health emergency. In May, the Department of Health and Human Services extended the emergency declaration past mid-July.
Some states like Vermont have enshrined access to these kinds of tele-health services into law through 2023, but those critical of federal law enforcement said the agency was extremely hesitant to regulate controlled substances. The DEA declined to comment on Politico’s story.
The National Institute on Drug Abuse released a study in October last year that said misuse of buprenorphine had actually decreased over the years from 2015 to 2019. Authors wrote that in 2019, less than 18% of those with opioid-use disorder got medication-assisted treatment “in part due to the stigma and barriers to accessing these medications.”
And it’s especially hard to gain access to the drug. Not only do health care providers normally need to go through a regulated program, doctors are limited in how many patients they can treat at one time, according to NIDA.
“High quality medical practice requires delivery of safe and effective treatments for health conditions, including substance use disorders,” Nora Volkow, NIDA’s director, said about buprenorphine. “This includes providing life-saving medications to people suffering from an opioid use disorder.”
A recent study tracked the availability of most opioid-relief medications like life-saving overdose treatment naloxone and buprenorphine. Researchers showed that the availability of the replacement drug ranged between 31 to 85% across nearly 5,000 pharmacies in 11 states. The drug is much harder to find outside of cities, and in states like California, less than a third of pharmacies carried the medication.
In an interview with Time, the drug-availability study’s authors said that the results may mean those in the health care industry often consider buprenorphine as “an optional part of their health care practice” instead of “our best tool to help people with opioid use disorder.”
That’s not to say there aren’t drawbacks to telehealth. Vokow told Politico that there could be issues when you proliferate these services. She cited mental health startup Cerebral that was accused by former employees of over-prescribing medications.
The issues for those dealing with addiction are compounding. The dearth of anti-addiction medication comes on the heels of reported supply shortages of Naloxone as well. Part of the issue is in manufacturing disruptions, as well as an inefficient distribution network.
But in the meantime, the opioid crisis remains a major issue across the United States. With new drugs exacerbating the lethality of abuse, the latest SAMHSA studies show 3.4% of the U.S. population—9.5 million people—misused opioids in 2020.