DEA’s Proposed Telehealth Rules For Prescribing Controlled Substances

Ketamine is the only psychedelic that can be lawfully prescribed (off-label) to treat mental health indications. It has also presented positive outcomes for a variety of conditions by individuals who were able to access ketamine-assisted therapy online via distance treatment modalities, especially during the pandemic.

The publication of the Ryan Haight Act (RHA) during the period of Public Health Emergency (PHE) left room for ketamine telehealth clinics to exponentially grow, as no first in-person consultation was required for physicians to begin prescribing ketamine to patients.

However, the Biden administration recently announced an end to many measures taken during the pandemic, effective as of May 11, 2023. 

The DEA proposed new rules for telehealth on Feb. 24, 2023. After the 30-day consultation period, the agency will consider public comments and may reevaluate or change rules. 

Set to “bridge between the DEA’s current PHE waivers and a post-PHE environment” (see Foley’s analysis), the regulations address several issues.

US-based practitioners with DEA permits to issue schedule III, IV and V controlled substances via telehealth will be able to continue doing so. Nonetheless, the RHA’s reincorporation will require a prior in-person consult unless a specified exception applies.

The aforementioned cases would be the qualifying telemedicine referral of a patient among practitioners including a performed in-person medical evaluation or a telemedicine relationship established during the PHE declaration (see Harris Bricken analysis.) 

Normally, practitioners would be able to issue online ketamine prescriptions for a 30-day supply, excluding cases of PHE declaration relationships, VA relationships, or when a medical evaluation is done.

Another newly-introduced restriction involves prescribers would now have to first …

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