Extending Pandemic Flexibilities for Opioid Use Disorder Treatment: Authorities and Methods

Abstract

This essay evaluates two specific flexibilities the government granted during the COVID-19 pandemic that made it easier for patients to access life-saving medications to treat opioid use disorder: buprenorphine and methadone. First, the Drug Enforcement Administration (DEA) allowed practitioners to prescribe buprenorphine using telemedicine without first conducting an in-person medical exam. Second, the Substance Abuse and Mental Health Services Administration (SAMHSA) made it easier for patients to have a take-home supply of methadone, reducing many patients’ need to make a daily trip to an opioid treatment program. While it is still early, there is some evidence that these flexibilities are working well for patients. Patients and practitioners worry that these flexibilities will come to an end after the pandemic, and one of the federal agencies involved has indicated that it lacks the legal authority to extend its flexibility beyond the pandemic. We disagree. At a political level, the White House Office of National Drug Control Policy has indicated that extending pandemic flexibilities for treating opioid use disorder is a priority for the Biden administration, and this essay offers a roadmap for the executive branch to extend these flexibilities using existing authority.

Note: Funding: we received financial support from the Pew Charitable Trusts to do the legal research that underpins this article.

Declaration of Interests: None to declare.

Keywords: opioids, pandemic, covid-19, regulation, regulatory, methadone, buprenorphine, public health emergency, dea, samhsa, ondcp, statutory interpretation, drug war, overdose