The Biden administration is making a play to set in stone the pandemic era-expansion of telehealth access for people struggling with addiction, offering up a series of suggestions for federal agencies and lawmakers in a new report.
The expansion, made possible by the declaration of a public health emergency for the Covid-19 pandemic, has opened new doors for treating Americans suffering from substance use disorder. But the White House’s Office for National Drug Control Policy says whether the impact will be positive in the long term remains to be seen, noting that both state and federal requirements will pose barriers to access upon the end of the pandemic emergency.
“Across the United States, fewer than 1 out of 10 people with substance use disorder get the care they need. That is unequivocally unacceptable,” Rahul Gupta, director of the ONDCP, said in a statement. Telehealth provides “a cost-effective way to increase access to care for vulnerable people with substance use disorder by meeting them where they are.”
In a report released Wednesday, the White House office laid out steps for broadening telehealth access for individuals struggling with addiction.
The plan calls for the federal government to weigh legislation or other steps to knock down barriers between state licensing systems for medical professionals that ONDCP says stand in the way of enacting nationwide telehealth efforts.
It also asks that the government make permanent and expand telehealth regulatory changes made available during the public health emergency, such as the US Drug Enforcement Administration permanently authorizing qualified professionals to prescribe controlled substances remotely without an in-person evaluation.
“Individuals living with SUD are part of a particularly vulnerable group of people who would likely benefit from increased accessibility to health care providers through telehealth,” the report said. “If some of these issues can be addressed and overcome, the future of health care in America can include telehealth services based on evidence-based, informed practices that are designed to be accessible to everyone.”
Telehealth in the Pandemic
Telehealth took on paramount importance during the Covid-19 pandemic. Citing Centers for Disease Control and Prevention data, the ONDCP report flags that telehealth visits jumped 50% between January and March 2020—the onset of the global pandemic— when compared with the same period for 2019.
Individuals with substance use disorder weren’t spared the impact of shelter-in-place requirements.
Important treatment programs like Narcotics Anonymous were suddenly halted, leaving those struggling with addiction without the sense of community important for the recovery process. A review of a half-million urine drug tests found a 32% jump in the presence of nonprescription fentanyl between mid-March and May 2020, the report said.
In response, the government modified the legal framework around telehealth, broadening access for Medicare telehealth services. Meanwhile, Congress appropriated $200 million for the Covid-19 Telehealth Program through the Coronavirus Aid, Relief and Economic Security (CARES) Act.
In the White House’s new push for broadening telehealth access, the office also suggests bolstering funds for mobile app services. But it warns that privacy and ethics need to be considered during a telehealth expansion, given that certain requirements for providers were waived under the public health emergency.