Ryan Haight And TREATS Act, And Treatment For Opioid Use Disorder

The Ryan Haight Act, the TREATS Act, and Other Telehealth Laws Affect Access To Opioid Dependency Treatment Telemedicine, often known as telehealth, is a type of virtual healthcare that is provided through the use of digital equipment such as phones and computers. It is a safe, effective, and frequently more accessible and convenient way for patients to meet with their medical professionals. Many services, such as chronic disease diagnosis and treatment, as well as behavioral health therapy, are available and effective through telemedicine.

Telemedicine has lately expanded to incorporate opioid use disorder therapy (OUD). This is critical since finding a practitioner trained to administer buprenorphine/naloxone to people suffering from opioid addiction is not always straightforward (Suboxone). There have been several challenges with healthcare access for patients with addiction in the past... Some people live in rural areas without access to clinicians who are educated in buprenorphine/naloxone (Suboxone) medication-assisted treatment... Others may feel ostracized if they seek treatment in person... Others may have jobs that don't allow them to take time off for medical appointments, causing them to choose between paying their expenses and getting treatment for their opioid addiction—telemedicine offers a solution to all of these issues.

Patients can track their symptoms and how they're feeling throughout the day using telemedicine, and that information is promptly communicated to their medical providers, allowing physicians to deliver the best possible care to patients in the present. This form of continuous surveillance and surveys throughout the day allows clinicians to have a better understanding of what triggers a patient's desires, allowing for a more customized treatment approach. Patients can also participate in online support groups through virtual health, which offers an extra degree of accountability and community support.

What about legislation governing telemedicine?

Treatment for opioid use disorder is governed by a few major telemedicine legislation. Let's start with the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which was signed into law on April 13, 2009.

Ryan Haight died at the age of 18 after overdosing on opioid prescription pills he'd purchased online from a medical practitioner he'd never met and an internet pharmacist who'd delivered the tablets to his house. The Ryan Haight Act was enacted as a result of this to fight unscrupulous online pharmacies selling prohibited medications. The US Drug Enforcement Administration is in charge of enforcing the Act (DEA). Before prescribing controlled medications, practitioners must complete at least one in-person medical evaluation, according to the Ryan Haight Act. The Act goes on to say that an in-person exam should be done at least once every 24 months as a cautious estimate.

Though the Ryan Haight Act has been somewhat successful in regulating online pill mills operating in the United States, it has created obstacles for people seeking telemedicine therapy for opioid addiction. The Ryan Haight Act regulates buprenorphine/naloxone (Suboxone) because it is a restricted substance.

The American Telemedicine Association has long lobbied the DEA to update the Ryan Haight Act, allowing clinicians to prescribe controlled substances via telemedicine without the need for an in-person evaluation—this is critical because the Ryan Haight Act remains a major roadblock for providers prescribing buprenorphine/naloxone (Suboxone) via telemedicine

Congress gave the DEA permission to create a "special registration" of telemedicine practitioners who are exempt from the in-person medical exam requirement under the Ryan Haight Act. H.R. 4131: Improving Access to Remote Behavioral Health Treatment Act of 2019 was sponsored by Congresswoman Doris Matsui (D-6th California's congressional district) on these grounds. The DEA is directed to register select community mental health centers with the power to prescribe prohibited narcotics via telemedicine under this bill, which is still making its way through Congress

As a result, until March 2020, when the COVID-19 pandemic swept across the United States, buprenorphine treatment was only available to patients who could be examined in person by an addictions medical specialist. Patients of Suboxone clinic, as well as those of many other telemedicine organizations, will have limited access to buprenorphine treatment as a result of this.

In the middle of the COVID-19 outbreak, telemedicine laws have been enacted.

The DEA temporarily waived the requirement for an in-person medical assessment prior to prescribing buprenorphine, and the Department of Health & Human Services (HHS) waived penalties for HIPAA violations, allowing patient-provider medical visits via FaceTime, Google Meet, or other videoconferencing as COVID spread across the United States in March 2020. The removal of these prohibitions has resulted in a large increase in access to buprenorphine treatment in times of crisis.

And it's a step in the right direction toward permanent procedures that make buprenorphine treatment possible without the need for an in-person medical evaluation. Senators Rob Portman of Ohio and Sheldon Whitehouse of Rhode Island presented S. 4103, the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act, on June 30, 2020. This bill would alter the Ryan Haight Act to allow buprenorphine treatment after a virtual medical examination with a doctor, eliminating the need for an in-person assessment. While this law is a positive step forward, it still requires audiovisual patient-provider appointments, which will be difficult for many Americans who do not have access to videoconferencing.

Suboxone clinic has signed the letter A Call for Equality: Telehealth to Improve Buprenorphine Access, which makes recommendations for more legislative action to improve buprenorphine treatment equity. You can also learn more about Suboxone clinic's efforts to improve health equity in buprenorphine treatment by clicking here.

What role do pill mills play in this?

Many people have heard of the term "pill mill" by now. Pill mills are clinicians, pharmacies, and clinics that inappropriately prescribe huge amounts of opioids with little or no medical examination of the patient, no diagnostic workup of the alleged health concern, and no due diligence to verify if patients already have opioid prescriptions. People travel from all over the country to obtain prescription opioids, and Florida, among other areas, has been renowned for its "pill mill tourism." Pill mills are dangerous... They've made a huge contribution to America's opioid crisis. Pill mills are increasingly being exposed/discovered and shut down, with many physicians and other staff members now facing criminal charges for facilitating pill mills. As a result, many pill mills have gone virtual, with those situated in the United States being found and shut down by law officials.

It goes without saying that telemedicine for opioid addiction therapy is unique. Regular video conferencing sessions with medical doctors, as well as health coaching, online support groups, and urine drug screen requirements, are all part of the treatment for opioid use disorder. Suboxone (buprenorphine/naloxone) is a safe, effective, and life-saving drug used to treat the addiction caused by in-person and online pill mills. Patients with opioid addiction are treated by telemedicine physicians who are invested in their rehabilitation.