When the COVID-19 pandemic hit in March of 2020, something unexpected happened: The COVID-19 public health emergency (PHE) temporarily waived limitations on telemedicine, making it possible for treatment programs to prescribe Suboxone (a formulation of buprenorphine that prevents misuse) to patients without an in-person visit. Even as the opioid crisis worsened, within a year of opening up access to treatment via telehealth, the rate of opioid-related overdoses and deaths began to decline.
Between January and August of 2022, researchers at CMS and NIH published studies showing that access to medications for opioid use disorder (MOUD) via telemedicine had reduced opioid-related emergency room visits and overdoses. In the eight months between those two studies, access to MOUD via telemedicine was supported by bipartisan leaders in Congress, a bipartisan coalition of state attorneys general and by the Biden White House.
With the PHE ending in May, DEA was required to update their requirements for writing buprenorphine prescriptions via telemedicine, and on Feb. 24, a summary of their proposed rules were published. The net effect of their proposal will restrict access to buprenorphine to a 30-day prescription via telemedicine.
This increases the risks to this vulnerable patient population, and once again, this isn’t my opinion. In 2003 the medical community learned that a 30-day opioid “detox” using buprenorphine has a 100 percent failure rate, compared with a 75 percent success rate for patients who received MOUD treatment with buprenorphine for at least 12 months. Six years later, in 2009, researchers found that 70 percent of OUD patients who tapered off of buprenorphine over a 28-day period had fallen back into illicit use within a month.
No matter how many new studies are run, the outcomes stay the same. Reducing access to buprenorphine increases overdoses, ER visits and deaths.
