Online Suboxone treatment can continue through 2025! But when will this flexibility be made permanent?
The regulations around telehealth are evolving. Frankly, they keep evolving, even as people receiving online treatment (and the clinicians providing it) hope for stable guidelines that will allow for effective treatment.
Online Suboxone treatment in 2025
The good news—and it is really good news!—is that the DEA recently finalized what they call the “Third Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications” Rule. This Rule extends the current telemedicine prescribing flexibility through December 31, 2025. That means that for the whole year of 2025, providers will still be able to prescribe controlled substances via telemedicine. This is a big win for folks in telehealth treatment for opioid use disorder.
What does this mean for my opioid use disorder treatment with Workit Health?
For right now, it means that nothing changes. Workit Health will still be providing care to members in Florida, Michigan, New Jersey, New Mexico, Ohio, and Texas. Because the DEA has extended current flexibilities through the next year, our providers will still offer 100% online treatment (including prescribing buprenorphine as appropriate) without an in-person visit.
When 2025 ends, it is possible that the regulations will change, but for the meantime, you can feel secure in your telehealth treatment program. Our team is watching the regulatory landscape closely, and we’ll alert our members ASAP if a change to the regulations might affect them.
Why was telehealth Suboxone treatment in question?
Before the COVID-19 pandemic, the Ryan Haight Act (officially, “Ryan Haight Online Pharmacy Consumer Protection Act of 2008”) included a requirement that a provider had to conduct an in-person medical examination of a patient in order to prescribe a controlled substance. Remember, buprenorphine—the main ingredient in Suboxone and other buprenorphine/naloxone medications that treat opioid use disorder—is a controlled substance. So when Workit Health started treating opioid use disorder in 2017, our members needed to travel to one of our in-person clinic locations for their first appointment before they could then continue their care via telehealth.
When the Ryan Haight Act was passed, it included some important exceptions, including one that said the Secretary of Health and Human Services could suspend the in-person requirement during a Public Health Emergency (PHE) is declared. The PHE around COVID-19 was declared on January 31, 2020. During the PHE, providers could conduct their medical examinations completely over the internet, with no in-person requirement.
Because video conferencing was available providers could connect with their patients face-to-face without ever being in the same room. This made treatment much more accessible for many people living in rural areas or treatment deserts, those with transportation or mobility concerns, and those whose responsibilities (like work, school, or dependent care) made it hard for them to get to in-person appointments. This flexibility has been powerful for Workit Health and our members, and research shows that telemedicine treatment for opioid use disorder is as effective as in-person treatment.
But. You’ll notice that that exception centered around the public health emergency, which ended in 2023. There was a lot of uncertainty about whether the regulations would go back to their old, pre-COVID state, or whether the flexibilities would be made permanent. So far, neither of those has happened. The flexibilities have been extended (and extended again), but they are still not permanent.
Is the DEA going to keep extending these prescribing flexibilities?
We don’t know. While we appreciate that this temporary extension will allow our providers to treat our members through our app-based program, we would be even more grateful if the prescribing flexibility were made permanent. Workit Health (and many other providers, health plans, and healthcare systems) will continue to advocate for a permanent solution so that telehealth providers can prescribe appropriate, life-saving medication without uncertainty and without unnecessary barriers.