- Healthcare providers in Connecticut will soon be able to use telemedicine to prescribe controlled substances for mental health and substance abuse treatment.
Gov. Daniel Malloy’s signature on S.B. 302 reverses the state’s prohibition on the prescription of Schedule 1, 2 and 3 controlled substances via telemedicine technology. Beginning July 1, providers will be able to prescribe Schedule 2 and 3 controlled substances (but not opioids) through virtual care platforms for treatment of patients with a substance abuse disorder or psychiatric disability.
“We are happy and grateful the Legislature agreed the law needed to change,” Melissa Welby, MD., Immediate Past President of the Connecticut Psychiatric Society, which led the lobbying effort for the new law, said in a release. “Now, patients throughout Connecticut – including those living in regions with shortages of local psychiatrists and addiction medicine specialists – will enjoy better access to quality psychiatric care because of telemedicine.”
Healthcare providers have long sought to use telemedicine and telehealth to treat patients with psychiatric and substance abuse issues who face barriers to access, arguing that a virtual care visit is just as productive as in-person treatment.
A key component of that treatment is medication-assisted treatment (MAT) therapy, defined as the use of medications approved by the federal Food and Drug Administration (FDA) that, in combination with counseling and behavioral therapies, provide a whole-patient approach to the treatment of substance use disorders.
But federal law – and in many cases state law – bans are severely restricts prescriptions of controlled substances through telemedicine. Federal regulation is channeled primarily through the Ryan Haight Act, passed in 2008, which prohibits physicians from prescribing controlled substances electronically until they have conducted an in-person examination, or if they meet the federal definition of practicing telemedicine, which requires that the patient be treated by, and physically located in, a hospital or clinic which has a valid DEA registration; and the telemedicine practitioner is treating the patient in the usual course of professional practice.
The nation’s ongoing opioid abuse crisis is creating a groundswell of support for changes in federal law to make telemedicine and telehealth a more prominent feature in treatment. Congress is currently considering several bills that would, if passed, create a special registration through the U.S. Drug Enforcement Agency to enable healthcare providers to prescribe controlled substances through telemedicine.
On the state front, meanwhile, Connecticut joins a handful of states looking to give providers more leeway to use digital health tools.
The state’s passage of S.B. 302 “is a huge benefit for Connecticut patients with mental health or substance use disorder issues, allowing these individuals to obtain better access to quality care,” Nate Lacktman, an attorney with the Foley & Lardner law firm and chairman of its Telemedicine Industry Team and co-chair of its Digital Health Work Group, said in his firm’s Health Care Law Today blog. “Industry advocates have applauded the Legislature and Governor for this change. Connecticut’s telepsychiatry and substance abuse treatment providers can now incorporate controlled substances into their therapies, which is an important and clinically significant component of these specialties.”
Foley, whose firm helped the Connecticut Psychiatric Society draft the language for the bill, said Connecticut providers still “must understand and navigate many intersecting state and federal laws on telemedicine, medical practice, fraud and abuse, and controlled substances.” That means complying with the Ryan Haight Act.
“The new law follows a growing trend among states to amend and eliminate prior statutory prohibitions on telemedicine prescribing of controlled substances, particularly in light of the goal of supporting the availability of alternative therapies to address the opioid crisis,” he concluded.