The COVID-19 outbreak has presented extraordinary challenges in prescribing buprenorphine to new and existing patients with opioid use disorder (OUD). Telemedicine presents an opportunity to reach these patients and promote continuity of care; however, rapidly evolving circumstances have caused confusion among many practitioners as to their rights and obligations under federal law when prescribing controlled substances using telemedicine technologies.
For instance, the Drug Enforcement Administration (DEA) published an information page describing what is required under the federal Controlled Substance Act to prescribe controlled medications through telemedicine, including the requirement to use audio-visual technology to conduct new patient exams. Shortly thereafter, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued an FAQ document for opioid treatment programs (OTPs) stating that DATA-waived practitioners may prescribe buprenorphine to new patients after conducting telephone-based exams. Nearly two weeks later, the DEA then posted guidance stating that, under normal circumstances, such telephone-base exams are “not consistent with the framework of the CSA” but are temporarily permissible during the public health emergency.
To help practitioners navigate the quickly changing legal landscape during the public health emergency, the Foundation for Opioid Response Efforts (FORE) has issued a legal opinion letter, prepared by DCBA associate Daniel McClughen, analyzing four hypothetical clinical scenarios for prescribing buprenorphine for OUD. The letter is published on the foundation’s Resources page, where stakeholders can access timely information related to practicing medicine during the COVID-19 outbreak.