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Telemedicine and Addiction Medicine

February 5, 2018

By: Corey Barton, Manager, Private Sector Relations


As we now know, patients struggling with opioid addiction often live in rural areas where there are few to no providers who can prescribe medications that are controlled substances as part of a treatment plan to treat addiction. The growth in the use of telemedicine represents a remarkable opportunity to use new technologies to care for those who lack access to transportation or endure other geographical barriers.  


However, certain barriers have prevented the widespread adoption of the use telemedicine to treat patients with addiction, particularly addiction involving opioid use. Specifically, the Ryan Haight Act, originally meant to regulate unscrupulous online sales of controlled substances, has maintained a general prohibition on the prescribing of controlled substances via the internet and requires an in-person examination of a patient. While the Act does contain exceptions for the “practice of telemedicine” that appear to allow the use of telemedicine to prescribe controlled substances such as buprenorphine for the treatment of addiction involving opioid use , addiction medicine providers have been hesitant to use telemedicine to treat patients due to the lack of guidance from the Drug Enforcement Administration (DEA) regarding the application of the Ryan Haight Act for the use of telemedicine to prescribe controlled substances to treat addiction.  


Reflecting the need for clarification from the DEA, many stakeholders, including Members of Congress have asked the DEA to issue regulations to clarify the Ryan Haight Act. While ASAM has not yet supported any specific efforts to address the Ryan Haigh Act, ASAM generally supports efforts that permit practitioners to prescribe controlled substances vis-à-vis telemedicine for the treatment of addiction so long as a patient has been appropriately evaluated and diagnosed by a qualified practitioner (but not necessarily the prescriber) using evidence-based criteria. Clarifying regulations would allow private and public payers to be better prepared to use existing codes to reimburse for telemedicine services related to the prescribing of controlled substances and therefore provide enhanced access to addiction medicine providers and services.  


As the field of addiction medicine evolves, ASAM encourages federal and state stakeholders to increase access to and improve the quality of treatment using evidence-based treatments and guidelines such as The ASAM Criteria and The ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. We look forward to working with the DEA, Congress, and others to ensure that patients have access to additional treatment options that incorporate the use of telemedicine.