Biden Proposal Would Ban Online Prescribing of Certain Drugs

The Biden administration on Friday proposed stricter limits on the online prescription of some medicationsincluding the attention deficit hyperactivity disorder drug Adderall and highly addictive opioids like 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 drugswould take effect after the Covid public health emergency ends on May 11, the Drug Enforcement Administration said in a statement.

The rise of telemedicine has expanded access to healthcare, especially in rural areas, during the pandemic. It also allowed doctors to write millions of prescriptions without even meeting the patients in person, creating the potential for misuse, critics say.

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 addiction treatment advocates, called them too 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 that restricting access to drugs like buprenorphine, which is used to treat opioid use disorder, will “kill people.” Opioid overdose deaths reached record levels in 2021.

But some health care providers and law enforcement officials have hailed the stricter rules as necessary to prevent misuse and abuse of controlled substances. DEA administrator Anne Milgram said inappropriate prescribing by online telehealth companies during the pandemic prompted her decision to propose the rules.

A Times investigation found that the telemedicine prescription of ketamine to treat depression had raised concerns about the potential for abuse and a lack of supervision. Some clinics providing telemedicine services for ketamine treatment failed to perform proper assessments and follow-up care, which could lead to patients receiving the drug without proper medical supervision.

Under the proposed rules, some medications, including Adderall and OxyContin, would first require an in-person meeting with prescribers. For some others, including buprenorphine and some non-narcotic drugs like Ambien, Valium, Xanax and ketamine, doctors will be able to prescribe a month’s supply via 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 public comment period, after which the DEA will issue a final rule, the agency said.