HHS proposes to make permanent telehealth flexibilities for doling out buprenorphine

The Biden administration is proposing to enable physicians to use telehealth to initiate the opioid treatment buprenorphine as part of an effort to curb overdoses. 

The Department of Health and Human Services (HHS) released a proposed rule Tuesday aimed at expanding access to treatments for opioid use disorder.

“These proposed updates would address longstanding barriers [to] treatment in regulations—most of which have not been revised in more than 20 years,” said Miriam Delphin-Rittmon, Ph.D., leader of the Substance Abuse and Mental Health Services Administration (SAMHSA). 

At the onset of the COVID-19 pandemic in March 2020, SAMHSA offered flexibility to physicians to use telehealth to initiate the substance abuse treatment buprenorphine in opioid treatment programs. 

It also enabled take-home doses of methadone. 

“Patients deemed stable by physicians have been able to take home up to 28 days’ worth of methadone doses; other patients—again, so determined by their physicians—received up to a 14-day supply,” according to a release on the proposed rule. 

HHS pointed to a recent study that showed patients who took advantage of these flexibilities experienced a positive impact on their recovery. 

SAMHSA proposes to expand the definition of an opioid treatment program practitioner to include any provider that has a license to dispense or prescribe approved medications. This expanded definition enables other types of practitioners such as physician assistants to prescribe and dispense such treatments.

It would also remove a one-year requirement for opioid addiction before a patient can enter a treatment program. The proposed rule would get rid of a requirement that practitioners who have a waiver to prescribe buprenorphine send an annual report to SAMHSA.

HHS is asking for comment on the rule by Feb. 14. 

The proposed rule is part of a larger effort by the Biden administration to combat a surge of overdoses during the COVID-19 pandemic.

HHS Secretary Xavier Becerra said the administration has worked to address the period between when a person becomes an addict and when they get treatment. 

“In between, you may do a lot of harm to yourself that’s irreversible,” Becerra said during a talk Tuesday at the Brookings Institution in Washington, D.C. “We’re going to do what we can and work with local communities to prevent the harm for damaging you long term as you get treated.”

He added that the federal government needs to work with states on the follow-up.

“We need to make sure that once you get clean, you stay clean,” Becerra said. “When we throw you back out into the world, it’s not always very nice.”