Washington, D.C. — Today, Representatives Annie Kuster (D-NH-02) and Carol Miller (R-WV-01) led nearly two dozen of their colleagues in sending a letter to the Director of the Office of National Drug Control Policy (ONDCP) Dr. Rahul Gupta, Attorney General Merrick Garland, and Secretary of Health and Human Services Xavier Becerra urging the Biden Administration and Drug Enforcement Administration (DEA) to preserve telehealth flexibilities for buprenorphine products approved to treat opioid use disorder (OUD). 

Current telehealth prescribing flexibilities are set to expire in December 2024, and the Drug Enforcement Administration (DEA) has proposed a rule that would require in-person visitations and increased regulations for telehealth prescribing of buprenorphine, a safe and effective controlled substance used to treat opioid addiction. The reported rule could limit patients’ ability to receive the life-saving care they have come to rely on.

The full letter is available here and printed below.

Dear Dr. Gupta, Attorney General Garland, and Secretary Becerra:

We urge you to preserve the existing telehealth flexibilities for buprenorphine products approved to treat opioid use disorder (OUD). 

Due to the COVID-19 pandemic, the Department of Justice, in coordination with the Department of Health and Human Services, allowed for the audio-video or audio-only telehealth initiation of buprenorphine, a medication approved to treat OUD. This lifesaving action and its subsequent extension by the Biden-Harris Administration have prompted sweeping changes to addiction care delivered via telehealth. The pandemic telehealth flexibilities increased access to buprenorphine for vulnerable Americans with OUD, improved addiction treatment retention, and reduced overdoses.

Those telehealth flexibilities are now set to expire in December 2024. Worryingly, the Drug Enforcement Administration’s (DEA) forthcoming rule reportedly includes new and onerous in-person visitation and burdensome special registration requirements for telehealth prescribing which will gut access to this life-saving medicine.

Our national public health response to the opioid epidemic has finally paid off: fewer people died from opioid overdoses over the 12-month period ending in April 2024. Now is not the time for the DEA to limit access to a key medical intervention that saves lives and prevents overdoses.

Congress has granted the DEA the authority it needs to maintain the existing telehealth flexibilities for buprenorphine products approved to treat OUD without in-person visitation requirements or a burdensome special registration. The DEA can use one of the “practice of telemedicine” exceptions under either 21 U.S.C. 802(54)(D) or (G) to extend telehealth flexibilities. Your Administration should use this authority to ensure people with OUD do not lose access to the medication they need.

There are at least two additional policy considerations that support allowing a more permissive initiation regimen via telehealth for buprenorphine. First, buprenorphine is a partial agonist medication, which makes it safer and less likely to be misused compared to full-opioid agonists.6 Second, the highly lethal illicit opioid market poses an immediate threat to the lives of Americans struggling with opioid use disorder. These facts should lead you to maximize access to buprenorphine as a tool to prevent overdoses and put people on the road to recovery, not limit access over a misplaced fear of diversion.

We urge you to ensure the DEA finalizes a telemedicine rule that extends existing telemedicine flexibilities for buprenorphine products approved for OUD without imposing unnecessary barriers to lifesaving treatment.

In addition to Representatives Annie Kuster and Carol Miller, the letter was signed by Representatives Lori Trahan, Paul Tonko, Claudia Tenney, Brian Fitzpatrick, David Trone, Brittany Pettersen, Dwight Evans, Michael Turner, Marc Molinaro, Mike Carey, Jay Obernolte, Brad Schneider, Madeleine Dean, Bill Keating, Becca Balint, Seth Moulton, Chris Pappas, Anthony D’Esposito, Sean Casten, Hillary Scholten, Eleanor Holmes Norton, and Bill Foster.

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