In late February, the United States Drug Enforcement Administration proposed pandemic rule changes that will affect certain controlled drugs that are more strictly regulated by the government once the public health emergency for COVID-19 expires on May 11. . In a nutshell, patients who were prescribed the controlled drugs during the pandemic would need to see a provider in person at least once to maintain their prescription. New patients could still get a month’s supply of many of these drugs, but then they would have to see their provider in person.
The telemedicine boom in the pandemic era has been a silver lining for many people over the past three years, at least from a health care access perspective. Along with the explosion of new businesses offering online healthcare, restrictions on how providers could treat and prescribe controlled drugs were relaxed, removing the need for a patient to see a doctor face-to-face for certain key medications, including those for mental health and opioids. addiction.
First, the good news: Prescriptions for many common drugs and medicines will remain available through online consultation once the public health emergency is over. Common medications people take to manage a health condition (insulin, blood pressure medications, contraceptives and more) will not be affected.
Proponents of the DEA’s proposed rules point to blind spots in telemedicine, such as the potential for abuse or overprescription of stimulants. But wider access to telemedicine has provided access to health care for those who find it difficult to meet a provider in person, including people who live in rural areas or find it difficult to get to. absent from work.
If finalized (nothing is set in stone now), the rules will alter care for some patients, although there are things you can do to prepare. There is also a proposed grace period for people who received prescriptions during the pandemic via telemedicine.
Here’s what we know.
During the pandemic, many people have embraced telemedicine services, especially for better access to healthcare for those who might not otherwise have it.
Mironov Konstantin/Getty Images
What the New DEA Rules Will (and Won’t) Affect
At this time, the pandemic rules for telemedicine are still in effect – the news may supersede them when the public health emergency for COVID-19 ends on May 11. (The DEA just completed a public comment period, during which citizens and health care groups submitted opinions on the proposal.) If they change, it will affect drugs differently depending on how they are. programmed: The DEA classifies them based on its perception of abuse potential and how the drug is used medically. Schedule I drugs are the most restricted class and include drugs you should be buying illegally under many circumstances, including cannabis, LSD and more. At the other end, Schedule V drugs include certain painkillers and cough medicines, such as Robitussin.
If the proposed rules come into effect and you have a prescription for a Schedule II drug, which includes Adderall and Ritalin, you will need to see a provider in person in order to fill or refill a prescription. If you have not had a non-telemedical visit with a provider, you will need to get one in order to continue your treatment.
For some common anti-anxiety medications, home ketamine treatment, medications for opioid abuse, and more, new patients will be able to get a month’s supply of medication (30 days), but will need to find a supplier in person to continue their treatment and obtain a refill. This includes drugs like Ambien, Xanax, and buprenorphine. Testosterone, which many transgender patients take as part of their hormone therapy, is also checked and will require an in-person appointment. Estrogen is not a controlled drug.
Here is a list of controlled substances so you can find out what class your drug is in. Here’s a graphic the DEA has for its proposed rule changes. To be certain of how your medications are categorized and how the rules will affect your particular case, consult your prescribing physician.
Then some leeway comes into play. According to DEA information for physicians, prescriptions written during the COVID-19 pandemic (from the time the public health emergency was first declared in 2020 until it expires next month), you will have an additional 180 days to get an in-person referral or assessment to keep your prescription active. This should apply to all medications, but check with your provider for specific prescription details. (As with all rules in the proposal, this too could change with the finalized version.)
Many common medications that you would be prescribed in an emergency care department or by your family doctor (such as antibiotics, contraceptives, and insulin) are not as strictly controlled by the government and will not be affected by changed rules. always be able to obtain them by telemedicine.
Changes in medications for opioid use disorder
Buprenorphine is one of the few drugs people can take to manage opioid use disorders, including heroin addiction. It’s basically a weaker version of methadone. If the new rules come into effect, people who get their first prescription for buprenorphine will have to find an in-person provider within a month in order to continue their treatment – which many addiction experts say is an obstacle to critical treatment.
How will this affect online ADHD treatment or mental health medications?
During the pandemic, there has been an explosion of online ADHD diagnoses and prescriptions, especially among young women. Sites such as ADHD Online, Cerebral and Done will all have to follow DEA rules for new prescriptions, if they go into effect later this spring.
According to the steps patients must take to keep their prescription active posted by ADHD Online, people with a prescription for something like Adderall will also likely be part of the pandemic-inspired 180-day grace period, which means you should have until early November to make an appointment or find a “qualified telemedicine reference” to have a patient stay on site.
Jordan Lye/Getty Images
How to find a supplier in person
Without the right connections, finding a provider who can prescribe controlled medications can be tricky and expensive. First, contact your insurance company if you have health insurance and ask them to guide you. You can also follow these medication-specific tips below.
Find an ADHD Provider
If you are a new patient looking for a new prescription for stimulant drugs (Schedule II drugs like Adderall) after May 11, you will need to find a provider in person who can diagnose and prescribe medication.
Additude Magazine, a publication for people with ADHD, has published a guide on what patients should consider when looking for a provider. It’s also worth noting that not all ADHD medications are stimulants, and non-stimulant types will have different rules than Adderall, for example.
General tips for finding a mental health care provider
Since DEA rules apply to drug prescriptions, mental health support will always be available through many telemedicine or online therapy companies – whether you’re seeking help for anxiety, depression , ADHD or whatever. Here is a list of the best online therapy options currently available, as well as the best psychiatry services.
Help finding therapy for opioid use
Buprenorphine can be prescribed in a doctor’s office, and new patients will be able to get a month’s supply if they begin treatment online after the DEA’s post-pandemic rules are in place. Then you will need to find another provider to continue the treatment.
If you don’t have a primary care doctor, checking with your local health department would be a great first step. If you started a prescription during the pandemic, your buprenorphine prescription will be kept for the additional 180 days, which means you will have a few extra months to find an in-person appointment. Major cities may have a directory of locations and phone numbers specifically for opioid addiction treatment, like this one in New York City.
People living in rural areas with fewer health care centers may have to travel longer distances to obtain health care. To help you narrow your search, the US Department of Health and Human Services offers a provider search. To use it, enter your postal code and the distance you can travel.
For help finding hormone therapy
Patients taking testosterone for gender-affirming care will also need to follow all updated post-pandemic telemedicine rules. Again, patients living in more rural areas may have more difficulty finding an in-person provider to hold a prescription.
If you don’t know where to look, contacting your local Planned Parenthood would be a good resource. Even if the branch does not prescribe your particular hormone therapy, they may be able to refer you to another location that does. And as with other health care services, if you don’t have a primary care physician, you can find and call your local health department to put you in touch with someone who can. get your medicine.
This story will be updated when the proposed rules go into effect, including any changes to what the DEA has planned at this time.
The information in this article is for educational and informational purposes only and is not intended to constitute medical or health advice. Always consult a physician or other qualified health care provider with any questions you may have about a medical condition or health goals.