At Citizens Health Hospital in Colby, Kansas, a pandemic-induced rule change allowed doctors to prescribe chronic pain and mental health medications instead of virtual appointments.
This has made life-changing medicines available to hundreds of patients in northwestern Kansas.
“Everyone struggles to access mental health care,” said Jenny Niblock, a nurse at the medical center. “It’s going to be even tougher in rural Kansas.”
Before the pandemic, the only way to get a prescription for federally regulated drugs was through an in-person doctor’s visit.
Allowing clinicians to remotely prescribe medications to reduce in-person visits and avoid further spread of the virus when the federal government declares the COVID-19 pandemic a national public health emergency bottom.
As a result, telemedicine appointments are now available, giving patients access to tightly controlled medications without leaving their homes.
The patient liked the change. As with doctors, there are persistent concerns that telemedicine could make more prescription drugs available to drug abusers.
But it brought with it some bad guys – companies and providers that got hit federal investigation With suspicion, they prescribed drugs without thoroughly diagnosing and monitoring patients.
Now the U.S. Drug Enforcement Administration is considering balancing the increasingly popular telemedicine with efforts to curb drug prescription abuse.
was suggested A rule released by the Biden administration in February proposed to restore some restrictions on telemedicine prescriptions when the public health emergency ended on May 11.
backlash from medical groups, including American Academy of Physicians and the American Hospital Association This provided a six-month extension to allow health care providers to continue prescribing drugs without an in-person visit. But providers remain unsure how to prepare themselves and their patients for the long term.
For drugs such as Vicodin, OxyContin and Adderall, proposed regulations would require in-person visits before prescribing these drugs. Telemedicine appointments are then cleared for refills.
Citizens Health is a critical access hospital and telemedicine is the only way Citizens Health can provide some specialized medical services, including psychiatric services. Only psychiatrists do not work in hospitals.
“We will lose access to mental health services if the psychiatrist is no longer able to prescribe medications because he never has the opportunity to see his patients face-to-face,” Niblock said.
This means that when restrictions return and prescriptions require face-to-face appointments, people will have to wait months for an appointment or drive hours to a major hospital.
“What we see all the time is that people don’t go,” she says. “Then they have no interest.”
Other drugs, such as buprenorphine, which is used to treat opioid addiction by suppressing appetite, will also be available via telemedicine for a month’s worth of prescriptions. However, replenishment requires direct booking.
Kansas is the second largest state in the United States increase rate Drug overdose rates in 2021.
Shane Hudson, president and CEO of CKF Addiction Treatment Company in Salina, Kansas, said treating drug use disorders is another area where providers are in short supply. He said some people may find it difficult to go to the clinic to renew their prescriptions after the first month.
“Some people will say, ‘Well, that’s fine,'” Hudson said.
But if you live in a remote area and have a limited income, you may not be able to get some treatment without telemedicine, he said.
CKF supports Gansang statewide through a network of health care providers that use telemedicine to connect people to treatment. This includes medications that CKF provides to about 200 patients.
Hudson said she understands why there is hesitation about the flexibility to prescribe all controlled substances through virtual appointments.
“That’s a valid concern,” Hudson said. “But that’s not the case with all of us.”
Deregulation during the pandemic has drawn some mental health startups. Both Cerebral Medical Group and Done Global Inc. provided rapid diagnosis of attention-deficit/hyperactivity disorder (ADHD) and prescriptions for Adderall and Xanax on social media.Both companies under federal investigation suspected of overprescribing.
“It really comes from the fact that we have to limit inappropriate prescribing at this point, and I think that’s a very legitimate concern…I don’t see evidence that it’s a big problem at this point. No,” said Professor Dr. Ative Meerotra. He holds a PhD in Health Policy and Medicine from Harvard Medical School.
Merotra said the DEA’s proposed restrictions take a more traditional criminal justice stance of prescribing controlled substances. He said surveillance of the bad guys is necessary, but so is a public health approach that removes barriers to care.
“We also need to maintain access for as many people as possible,” Melotra said.
Hudson said the regulation could curb abuse of telemedicine prescriptions. But blanket policies hurt addiction treatment centers like him, which try to reach as many patients as possible, he said.
More than 38,000 responses were received during the 30-day comment period on the Biden administration’s proposed rule.
that’s the federal government Recent announcements It announced that it will extend remote prescribing flexibility for an additional six months. A patient who has established a telemedicine relationship with a healthcare provider by November 11, 2023 will be given a one-year grace period until he must comply with the new telemedicine regulations.
The delay provided temporary relief for Northwest Kansas provider Jenny Niblock.
“In rural Kansas, I used to say, ‘I lived another day,'” says Niblock. “So I bought six more months.”
Samantha Horton has reported her health to the Kansas News Service. You can follow her on her Twitter @Sam Horton5.
The Kansas News Service, a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio, focuses on health, the social determinants of health, and their relationship to public policy.
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