HHS urging providers to use telemedicine for medication-assisted opioid treatment 

HHS is pushing providers—particularly those in rural areas—to take advantage of telemedicine to increase access to medication-assisted addiction treatment (MAT). 

But providers seeking to prescribe these medications require waivers, which can hinder access, especially in remote areas where doctors with these qualifications are in short supply. 

So the Department of Health and Human Services and the Drug Enforcement Administration have worked together to ease these restrictions. Doctors can now prescribe buprenorphine, one of the most commonly used drugs for MAT, through a virtual platform, when before these clinicians had to be physically present with patients to offer these prescriptions. 

“Not everyone is waivered, and as you might imagine, particularly in underserved areas there’s a profound shortage" of these clinicians, Brett Giroir, M.D., assistant secretary for health and senior adviser for opioid policy, said at a press briefing on Thursday. 

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As long as a clinician with a DEA number, which can include advanced practice providers who aren't doctors, is present with the patient at the time of the consult, the waivered provider on the other end of the line can prescribe buprenorphine when deemed appropriate, Giroir said.

MAT, used in conjunction with other options such as psychological services, is a crucial way to address opioid addiction. Boosting access to MAT, particularly in rural regions hit hardest by the opioid epidemic, was one of a slew of recommendations issued late last year by the White House’s opioid commission.

The MAT waiver adjustments were made earlier this year, but HHS is now issuing a full-court press on alerting providers to their telemedicine options for opioid treatment, Giroir said. 

HHS is taking steps to get the word out after a Substance Abuse and Mental Health Services Administration report showed progress in efforts to address the opioid crisis, such as fewer new heroin users and a decline in the number of people misusing opioids in 2017. More people got into treatment for opioid use disorder, as well, according to the report. However, more than 11 million American adults used opioids inappropriately last year, the report estimates. 

Tackling the opioid crisis is a top priority for HHS and is one of Secretary Alex Azar’s central agenda items. At the briefing, Azar also noted that the agency had released $1 billion in grants for programs to address the epidemic. 

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“All of these actions are part of a well-coordinated strategy that we are bringing to bear here at HHS,” Azar said. “We’re tackling a problem that we have been dealing with for decades and did not get into overnight.” 

Giroir said addressing the waiver problem is a clear example of why it’s crucial that the Trump administration takes a multiagency approach to combat the opioid epidemic. Effective solutions require not just HHS but also the Department of Justice, the Department of Housing and Urban Development and the Department of State, among others, he said. 

“There is almost no single part of the solution that can be done in a silo,” Giroir said. “It must be done across the agency in a synergistic way.”