On Tuesday, April 24, 2018, the Senate Committee on Health, Education, Labor & Pensions (HELP) unanimously passed the Opioid Crisis Response Act of 2018. This bipartisan committee consulted with officials and subject-matter experts from the US Food and Drug Administration (FDA), the Centers for Disease Control (CDC), the National Institutes of Health (NIH), the Substance Abuse and Mental Health Services Administration (SAMSHA) as well as mental health experts, state governors and families affected by drug abuse to establish 40 proposals for responding to this health crisis.
A key component of their response involves increasing the utilization of Telemedicine.
According to the National Institute on Drug Abuse, “[an]estimated 2.1 million people in the United States had a substance use disorder related to prescription opioid pain medicines in 2016,” and although effective medications are available to treat this addiction, “fewer than half of private-sector treatment programs offer [these medications], and of patients in those programs who might benefit, only a third actually receive it.
Telemedicine may be key to removing some of the obstacles to making these medications more available.
Ryan Haight Act of 2008
A primary obstacle to the use of Telemedicine in treating opioid addiction is the Ryan Haight Online Pharmacy Consumer Protection Act of 2008. This act was designed to prevent abuses from internet pharmacies that became popular in the 1990’s. According to the legislation, in order to prescribe controlled substances electronically, physicians must conduct an in-person examination of the patient, or the patient must be physically located in a hospital or clinic with a valid DEA registration. The DEA issued regulations that imposed a federal prohibition on form-only online prescribing of opioids and placed limits on the electronic prescription of controlled substances.
Although the legislation provided for a special registration that would have allowed physicians to prescribe controlled substances without meeting these requirements, the DEA failed to make this registry available. The Opioid Crisis Response Act is an attempt to compel the DEA to follow through on this provision.
Opioid Crisis Response Act of 2018
This comprehensive legislation includes forty proposals, attacking the opioid crisis from multiple angles. These provisions would enable the DEA to allow qualified healthcare providers to prescribe controlled substances using Telemedicine, expand the list of qualified providers to include community mental health and addiction treatment centers, and give more freedom for physicians, physician assistants, and nurse practitioners in prescribing medication-assisted therapy to patients who struggle with opioid addiction.
By making it easier for physicians to prescribe controlled-substances to help addicts, these medications will become far more accessible to the people who need them most, and to patients living in under-served rural areas. This legislation will go into effect within one year, following a 60-day comment period allowed by the attorney general.
Other provisions of the bill include:
- States will be encouraged to share prescription drug monitoring programs (PDMP) with one another to allow doctors and pharmacies to know if patients have a history of substance abuse.
- The HHS secretary will issue guidance every year informing providers what kind of information they can share with relatives about opioid-related emergencies and overdoses.
One advocacy organization, Shatterproof, provided the Senate with recommendations. Shatterproof founder and CEO Gary Mendell had this to say: “The Senate HELP Committee today made important progress in the fight against the opioid crisis by advancing this bipartisan legislation. We welcome the provisions to establish Comprehensive Opioid Recovery Centers and improve existing state Prescription Drug Monitoring Programs (PDMPs). As the bill moves to the full Senate, we urge senators to continue to improve upon the bill by including provisions to limit opioid prescriptions for acute pain to three days, require states to meet minimum best practices for PDMPs, and incentivize evidence-based approaches to treating substance use disorders. If passed, these smart, common-sense provisions will start saving lives immediately.”
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