Restricting telemedicine prescriptions for opioid use disorder could undermine recovery

Restricting telemedicine prescriptions for opioid use disorder could undermine recovery

Researchers at Weill Cornell Medicine found that restricting telemedicine prescriptions for opioid use disorder is preventing thousands from accessing buprenorphine, a drug that helps people recover from addiction. The study, published March 3 in Jama Network Open, warns against requiring in-person visits—as proposed by the Drug Enforcement Agency (DEA)—the progress made during the Covid-19 pandemic when Telhealth increased access to this life-saving treatment. Previous studies show that telemedicine buprenorphine prescriptions improve treatment utilization and reduce overdose rates.

Before the pandemic, federal law required doctors to personally examine patients before prescribing controlled substances. This rule was temporarily suspended in March 2020, allowing physicians to prescribe buprenorphine through online telemedicine visits, making it easier to treat opioid use disorder, particularly for those in rural areas or without reliable transportation.

If this personal rule had been in place from 2020 to 2022, 4,500 patients in the large national sample we studied would have missed treatment. “

Dr. Beth McGinty, lead author and Livingston Farrand Professor of Population Health Sciences at Weill Cornell Medicine

The study was carried out with Dr. Matthew Eisenberg, associate professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, led.

For many struggling with opioid addiction, telehealth is a lifeline that can lead to recovery, said Dr. McGinty. The study's findings could guide policymakers in developing evidence-based telehealth regulations that ensure safe and responsible prescribing.

Researchers analyzed approximately 229,000 initial buprenorphine prescriptions in the United States between 2020 and 2022, with nearly 10% of these initiated via telehealth. Among these, approximately 28% of patients had not seen their prescriber in the past two years, and 20% had not had a follow-up visit two years before starting treatment or within 30 days.

The researchers found that patients with Medicare (28%) and private insurance (26%) are more likely to begin treatment without an in-person visit than those on Medicaid (16%). Additionally, behavioral health physicians and nurses, who often serve communities with high levels of opioid addiction and overdose, were more likely to prescribe as primary care providers than primary care physicians without an in-person visit.

Although the DEA ruled in January 2025 that registered practitioners could prescribe buprenorphine via telemedicine for an initial six-month supply, implementation is pending in the current administration's review.

“Permitting telehealth treatment initiation and continued prescribing six months before an in-person visit is required helps address concerns that restrictions may impact access to life-saving buprenorphine due to limited availability or transportation barriers to in-person appointments,” said Dr. McGinty. “As the debate over telehealth policy continues, this study highlights the importance of preventing unnecessary barriers to those recovering.”

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