AG Racine and 44 AGs Call for Extension of Pandemic Telehealth Flexibilities to Provide Those With Opioid Use Disorder More Accessible Treatment

Continues AG Racine’s Leadership and Efforts to Combat the Opioid Epidemic 

WASHINGTON, D.C. – District of Columbia Attorney General Karl A. Racine joined a bipartisan coalition of 45 attorneys general urging the Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Services Administration (SAMHSA) to permanently extend telehealth flexibilities beyond the expiration of the COVID-19 public health emergency for prescribing buprenorphine, a Food and Drug Administration (FDA) approved medication used to treat opioid use disorder. 

“Protecting the health and safety of our residents is my top priority. And that includes addressing and ending the opioid crisis that has had a devastating impact in the District, particularly on DC’s Black and brown communities,” said AG Racine. “It is crucial that life-saving treatments for opioid use disorder are made accessible to all. And we can help do this by extending the pandemic telehealth flexibilities.”

In a letter to Attorney General Merrick Garland, Secretary Xavier Becerra, Administrator Anne Milgram, and Assistant Secretary Miriam Delphin-Rittmon, the attorneys general explain that in mid-March 2020, due to the COVID-19 public health emergency, the DEA allowed audio-visual telemedicine services for initiating all schedule II-V controlled substances, including buprenorphine, without conducting an in-person evaluation.  

Later that month, the DEA allowed prescribers to have the flexibility to prescribe buprenorphine via telephone, without the need for an in-person or video evaluation. These flexibilities are set to expire when the COVID-19 health emergency ends, which could prevent up to 2.5 million adults throughout the U.S. who use buprenorphine from obtaining treatment via telemedicine. Many of these individuals may struggle to otherwise access buprenorphine because they live too far away from a buprenorphine provider to get in-person treatment. 

The attorneys general further explain that when telehealth flexibilities were allowed the number of patients receiving buprenorphine as treatment for an opioid use disorder increased significantly, and that number expanded as the public health emergency continued. These telehealth flexibilities led to an increase in buprenorphine initiation and improved the retention in care and lessened the chance of overdose for individuals prescribed buprenorphine via telehealth for opioid use disorder treatment.  

The attorneys general also argue that since the SAMHSA has permanently extended the flexibilities of methadone, a medication used to treat opioid use disorder, by continuing to allow take-home doses after the public health emergency expires, the same action should be taken to extend the flexibilities granted to buprenorphine.  

Joining AG Racine in sending the letter are the Attorneys General of Florida, North Carolina, Arizona, California, Colorado, Connecticut, Delaware, Georgia, Guam, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. 

A copy of the letter AG Racine and 44 other attorneys general sent is available here

Addressing the Opioid Crisis
This letter builds on AG Racine’s efforts to address the national opioid crisis and protect District residents from harm. In September 2022, AG Racine testified on the Opioid Litigation Proceeds Act of 2022. In early 2022, Attorney General Racine announced that several companies involved in the opioid industry will pay the District tens of millions of dollars, which will be used for needed support for District residents struggling with opioid use disorder. In September 2021, AG Racine led a coalition of 11 attorneys general in urging the Supreme Court to hear cases supporting states’ rights to enact public health policies that will protect their residents from opioid overdose deaths. In February 2021, AG Racine announced a $573 million settlement with McKinsey & Company, one of the world’s largest consulting firms, over its role in worsening the opioid epidemic. 

In July 2020, AG Racine led a 10-state coalition supporting states’ rights to enact policies geared towards opioid overdose prevention. In April 2021, AG Racine was a part of a $300 million multi-state settlement agreement with the pharmaceutical manufacturer Indivior, over Medicaid fraud allegations and the false marketing of Suboxone, which is approved for use by those recovering from opioid use disorder to avoid or reduce withdrawal symptoms. In 2018, the DC Council passed a permanent version of the Synthetics Abatement and Full Enforcement Drug Control Act (Safe DC) proposed by AG Racine to make it easier to prosecute the suppliers and distributors of dangerous drugs, including the synthetic opioid fentanyl. In 2016, AG Racine testified on the Substance Abuse and Opioid Overdose Prevention Amendment Act.