A bipartisan coalition of U.S. Senators is pressing the Biden administration to make permanent the COVID-19-era regulatory changes that have expanded access to virtual medication-assisted treatment (MAT) through telehealth. Sens. Rob Portman (R-Ohio) and Sheldon Whitehouse (D-R.I.) sent a formal letter on April 1 to the top officials at the Department of Health and Human Services (HHS) and the Drug Enforcement Administration (DEA), urging them to finalize the rulemaking process that would codify the temporary flexibilities introduced during the pandemic.
These flexibilities have been vital in increasing treatment accessibility for individuals struggling with substance use disorders (SUD), particularly opioid use disorder, a condition that continues to devastate communities across the country. The Senators called the regulatory changes a “game-changer” based on feedback from providers in their home states who witnessed firsthand how virtual medication-assisted treatment expanded access and improved patient outcomes.
The Impact of Telehealth in Medication-Assisted Treatment
Before the pandemic, strict regulations required patients to visit providers in person to begin or maintain MAT involving controlled substances like buprenorphine and methadone. This presented a significant barrier for many people, especially those living in rural or underserved areas without easy access to addiction specialists.
In March 2020, the DEA issued a waiver allowing practitioners to initiate and manage MAT remotely using telehealth technologies. This waiver enabled patients to receive life-saving treatment without the burden of traveling long distances or risking exposure to COVID-19.
Providers across the nation quickly adapted, and many reported increased engagement and retention rates in treatment programs. The flexibility also helped reduce stigma by allowing patients to access care discreetly from their homes through virtual medication-assisted treatment.
A Growing Urgency Amidst the Opioid Crisis
The overdose crisis remains one of the most pressing public health challenges in the U.S., with tens of thousands of lives lost each year due to opioid-related overdoses. Medication-assisted treatment is widely recognized as a critical evidence-based intervention proven to reduce overdose deaths, support recovery, and improve long-term outcomes.
By permanently expanding telehealth access for MAT, more individuals will have the opportunity to start and continue treatment without unnecessary barriers. This can help curb the surge of overdoses and improve quality of life for countless Americans. The expansion of virtual medication-assisted treatment plays a central role in these efforts.
Sens. Portman and Whitehouse emphasized this in their letter:
“We have heard from countless substance use providers in our home states who describe this waiver as a ‘game-changer’ in expanding access to treatment for individuals with substance use disorder and combating the current surge of drug overdoses.”
Legislative Momentum and the Senate Finance Committee’s Role
Both Senators serve on the Senate Finance Committee, which is leading the charge on behavioral health legislation expected to be introduced in early summer. Medication-assisted treatment has been a major focus of recent hearings, underscoring its importance in any comprehensive behavioral health reform.
Senate Finance Committee Chairman Ron Wyden (D-Ore.) has been vocal about the urgency of the crisis, warning that “time has run out” for health insurance plans that fail to comply with reimbursement parity for behavioral health services. Ensuring fair reimbursement is essential for providers to sustainably offer expanded telehealth services, including virtual medication-assisted treatment.
The bipartisan nature of the push from Senators Portman and Whitehouse demonstrates broad political recognition of the importance of maintaining these telehealth flexibilities to combat addiction.
Signals from the DEA on Permanent Rulemaking
There are encouraging indications that the DEA is open to making the telehealth waiver permanent. DEA Administrator Anne Milgram issued a statement on March 23 affirming the agency’s commitment to expanding access to medication-assisted treatment:
“In this moment, when the United States is suffering tens of thousands of opioid-related overdose deaths every year, the DEA’s top priority is doing everything in our power to save lives. At DEA, our goal is simple: we want medication-assisted treatment to be readily and safely available to anyone in the country who needs it.”
The senators requested an update on the DEA’s timeline for rulemaking by April 15, pressing for swift action to ensure that regulatory certainty is established while Congress finalizes its behavioral health legislative package.
Why Making These Changes Permanent Matters
The pandemic revealed the potential for telehealth to transform behavioral health care delivery. For individuals with substance use disorder, the ability to start and continue MAT virtually has reduced barriers related to transportation, childcare, stigma, and COVID-related health concerns. It also allows providers to reach a wider population, including those in rural and underserved areas.
However, without permanent regulatory changes, these gains risk being reversed. If the telehealth flexibilities expire, patients may be forced back into burdensome in-person visits, disrupting continuity of care and potentially leading to relapse or overdose.
Locking in these changes through formal rulemaking provides stability for providers and patients alike, ensuring that expanded access to this critical treatment via virtual medication-assisted treatment remains a permanent fixture in the nation’s addiction response.
The Future of Behavioral Health Policy
As Congress continues to develop a comprehensive behavioral health reform package, the fate of virtual medication-assisted treatment will be a critical component. Alongside efforts to enforce parity in reimbursement and increase funding for treatment programs, permanently embracing telehealth can make a substantial difference in improving outcomes and saving lives.
The bipartisan advocacy from Senators Portman and Whitehouse, combined with the DEA’s expressed commitment, offers hope that the nation’s behavioral health system will evolve to better meet the needs of those affected by addiction.
Conclusion
Virtual medication-assisted treatment is a proven and essential tool in the fight against substance use disorders, particularly opioid addiction. The COVID-era telehealth flexibilities allowed by the DEA have expanded access to MAT, reaching individuals who might otherwise be left untreated.
Now, bipartisan leaders in the Senate are pushing to make these changes permanent, recognizing the urgent need to sustain expanded treatment access amid the ongoing overdose epidemic. The DEA’s commitment to this goal and the forthcoming legislative efforts suggest positive momentum.
For individuals and families affected by substance use disorders, this could mean easier access to life-saving care and a better chance at recovery in the years ahead.
If you or someone you know is struggling with opioid use or other substance use disorders, it’s important to explore available treatment options, including telehealth services that offer virtual medication-assisted treatment. Staying informed about these regulatory changes can help ensure access to the best possible care when it’s needed most.
