Tighter limits for some Rx drugs proposed

U.S. rules change would partially reverse some pandemic telemedicine policies

The Biden administration proposed Friday tighter limits on the online prescription of some medications, including the attention deficit hyperactivity disorder drug Adderall and highly addictive opioids such as oxycodone, a partial reversal of policy changes made during the coronavirus pandemic.

The new regulations, which would require health care providers to have at least one in-person visit with patients before prescribing or refilling certain drugs, would take effect after the public health emergency for covid ends May 11, the Drug Enforcement Administration said in a statement.

The rise of telemedicine expanded access to health care, particularly in rural areas, during the pandemic. It also allowed doctors to write millions of prescriptions without ever meeting patients in person — creating the potential for misuse, critics have said.

The rule change, part of the DEA’s efforts to combat the deadly opioid epidemic in the United States, seeks to balance the advantages of telehealth with more safeguards, according to the agency.

Some experts, including advocates for addiction treatment, called them overly restrictive, possibly making it harder for patients to get the care they need.

Matthew Cortland, a senior fellow at Data for Progress, a left-leaning think tank, said on Twitter restricting access to drugs like buprenorphine, which is used to treat opioid use disorder, “will kill people.”

Deaths from opioid overdoses hit record levels in 2021. But some health care providers and law enforcement officials have praised the tighter rules as necessary to prevent the misuse and abuse of controlled substances.

Anne Milgram, a DEA administrator, said improper prescribing by online telehealth companies during the pandemic prompted its decision to propose the rules.

A New York Times investigation found that the prescription of ketamine via telemedicine to treat depression had raised concerns about the potential for abuse and lack of oversight. Some clinics providing telemedicine services for ketamine treatment did not conduct adequate screenings or follow-up care, potentially leading to patients receiving the drug without proper medical supervision.

Under the proposed rules, some drugs, including Adderall and OxyContin, would require an in-person meeting with prescribers first. For some others, including buprenorphine and some nonnarcotic drugs like Ambien, Valium, Xanax and ketamine, medical practitioners will be allowed to prescribe a onemonth supply through telemedicine, with an in-person consultation required for refills.

Patients will still be able to get medications like antibiotics, skin creams, birth control and insulin entirely through telemedicine.

The proposal will undergo a 30-day period of public comment, after which the DEA will issue a final rule, the agency said.