A bipartisan group of senators this week introduced a bill that would permanently allow health providers to prescribe buprenorphine, a common medication used to treat opioid addiction, via telehealth.
The measure, known as the Telehealth Response for E-prescribing Addiction Therapy Services Act — TREATS, for short — would permanently extend a temporary, Covid-era policy that allowed patients to receive buprenorphine remotely, without an in-person visit.
While certain law enforcement officials have expressed concern that buprenorphine prescribed remotely could be misused, addiction treatment experts say there’s little evidence to that effect. Amid a public health crisis, they argue, any restrictions on lifesaving medications like buprenorphine would hurt far more than they help.
“During the depths of the Covid-19 pandemic, telehealth sessions were a lifeline for those walking the long road to recovery while dealing with stress and isolation,” Sen. Sheldon Whitehouse (D-R.I.) said in a statement. “Our bipartisan legislation would make telehealth flexibilities permanent to ensure that lifesaving recovery support continues to be widely available from the comfort of home.”
The bill’s other authors are Sens. Lisa Murkowski (R-Alaska), Marsha Blackburn (R-Tenn.), and Mark Warner (D-Va.).
Lawmakers first introduced the TREATS Act in 2021, though it gained little traction. Its reintroduction on Wednesday, however, comes amid continued debate over a controversial proposal from the Drug Enforcement Administration that would require patients to visit a prescriber in-person within 30 days of receiving a prescription remotely.
That proposal generated intense blowback from addiction treatment advocates and Democratic lawmakers, as well as provider groups like the American Society of Addiction Medicine. Numerous digital health companies, like Bicycle Health and Boulder Care, have used the flexibilities to significantly expand their reach and buprenorphine prescribing volume.
The DEA has extended its deadline for making a final decision multiple times. Currently, the Covid-era telehealth flexibilities are set to expire at the end of 2024.
Buprenorphine is one of two medications approved by the Food and Drug Administration to treat the withdrawal symptoms and cravings that occur when people attempt to stop using opioids. Buprenorphine and another common medication, methadone, are viewed as the gold standard for treating opioid use disorder.
Both medications are opioids themselves, however, prompting some fears that unfettered access could carry unintended consequences like misuse or even overdose. Studies from the Covid era, however, show that the share of opioid overdoses involving buprenorphine did not meaningfully increase after the new telehealth flexibilities were put in place.
“Research shows that during the COVID-19 pandemic, telehealth access to buprenorphine transformed treatment,” Brandee Izquierdo, the director of behavioral health programs at the nonprofit Pew Charitable Trusts, said in a statement. “More patients have started and stayed in treatment over the past three years than in years previous — without increasing overdose deaths. These patients didn’t have to endure long waits for appointments; they didn’t have to take off work, find transportation, or pay for childcare. And they didn’t have to face the judgment or stigma that too often comes with in-person office visits.”
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