Congress Needs to Save Telehealth Treatment for Addiction

Telehealth has helped more patients with opioid use disorder (OUD) get access to treatment over the past few years than ever before.  

But this critical lifeline to care will go away by year’s end unless Congress acts.  

At the onset of COVID-19, the federal government put in place temporary regulations allowing patients with OUD to receive buprenorphine—a medication that reduces their craving for opioids that has been proved to reduce overdose deaths and help people stay in treatment—from providers via telehealth. These regulations expire Dec. 31, and without congressional action, patients will be forced to return to in-person appointments in order to receive buprenorphine and will face the same barriers to treatment that telehealth removed.

In-person care can be hard to find—health care providers may not have in-office appointments available for weeks, despite the patient’s need for immediate treatment. When they do book an appointment, patients often must arrange child care or take time off work. In-person care requires people who live in more rural areas to travel long distances or pay for transportation. And it forces them to face the stigma and discrimination that so often accompanies patients seeking addiction treatment in medical facilities.

The bipartisan Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act would remove these barriers for good by permanently allowing people with OUD to initiate and continue buprenorphine treatment by video or audio telehealth appointments. In a country where just 1 in 4 people in need of treatment services receive any, expanding access to buprenorphine via telehealth is the best way to connect more people to lifesaving care.

And data from the past several years makes it clear that remote access to buprenorphine is safe and effective.

Telehealth access to buprenorphine has allowed more patients to start and stay in treatment without increasing buprenorphine-related overdoses. It has helped to close gaps in care for communities with already-low treatment rates. Since the onset of telehealth access, veterans accessing buprenorphine via telehealth have been more likely to stay in treatment than those seen in person. More people who live in remote rural areas or lack adequate transportation or child care are getting the care they need. And Medicare recipients who received telehealth services have been more likely to maintain their treatment and less likely to overdose than recipients who received in-person care before the pandemic.

Notably, the TREATS Act would allow patients to receive buprenorphine treatment via audio-only visits, which is critical for connecting to treatment for people without reliable internet access or the technology to conduct video calls. Numerous studies show that audio-only care is as safe, effective, and high-quality as audio-video appointments; that patients and medical providers are satisfied with the care provided and delivered; and that patients are no more likely to misuse their prescriptions or give or sell them to another person (a practice known as diversion).

In fact, the Drug Enforcement Administration and the National Institute on Drug Abuse have both confirmed that expanding access to buprenorphine decreases diversion of the drug. And when diversion does happen, it’s usually because people unable to access treatment that would allow them to obtain the drug legally are trying to manage withdrawal symptoms.

The TREATS Act would also help assure health care providers that the time and resources they invest in setting up remote care will not be wasted, leading to more providers being able to deliver this lifesaving care to OUD patients. In one study, providers expressed reluctance to offer telehealth services because of the lack of clarity around temporary regulations and their concerns about transitioning patients back to in-person care once the telehealth regulations expire. But they voiced unanimous support for making the temporary regulations permanent.

As we mark National Recovery Month this September, the facts are clear: Remote access to buprenorphine connects more people to treatment and saves lives. And now, with lives at stake, there’s little time left for Congress to act. We urge lawmakers to pass the bipartisan TREATS Act immediately.

Alexandra Duncan and Marcelo Fernández-Viña work on The Pew Charitable Trusts’ substance use prevention and treatment initiative.

This op-ed was first published in The Hill on September 18, 2024.