At the age of 93, suffering from the effects of stroke, heart failure and recurrent cancer, Terry Sheridan was ready to take his own life under New Jersey laws allowing medically assisted suicide.
On November 17 of last year, surrounded by her three children, Sheridan took a lethal dose of medicine prescribed by a doctor whom she met in person only online. She died within minutes.
Soon, others seeking Sheridan’s final option may find it out of reach. This is an unintended consequence of the federal government curtailing online prescriptions. Number of potentially addictive drugs permitted during the COVID-19 pandemic.
“How much should one person suffer?” said Georgen White, 68, Sheridan’s daughter.
Online prescription rules for controlled substances were relaxed three years ago under the Emergency Waiver to ensure the availability of critical medicines during the COVID-19 pandemic. Currently, the U.S. Drug Enforcement Administration rule This revives most of the previous longstanding requirement for doctors to see patients in person before prescribing narcotics such as OxyContin, amphetamines such as Adderall, and a host of other potentially dangerous drugs.
The aim is to reduce inappropriate prescribing of these drugs by telemedicine companies that have boomed during the pandemic. Given the ongoing opioid epidemic, continuing to allow the widespread use of telemedicine prescriptions “poses a very large risk to public health and safety,” the proposed rule said. . It also cracks down on how doctors prescribe other less addictive drugs, such as Xanax, used to treat anxiety, and buprenorphine, a narcotic used to treat opioid addiction.
The rule will allow some of these drugs to be prescribed via telemedicine in doses for the first 30 days, but patients will need to see a doctor in person to receive refills. Also, patients who have been referred to a new doctor by a previously in-person doctor can continue to receive prescriptions via telemedicine.
DEA Administrator Ann Milgram called the plan “telemedicine with guardrails.”
A spokesperson for HHS said it was working with information from the Department of Health and Human Services to finalize the rules by May 11, when the COVID-19 public health emergency officially ends. . If approved by then, the new requirements will go into effect in November.
The proposal provoked massive backlash, including: 35,000 comments Submit to federal portals and appeals from advocates, members of Congress, and medical groups to review specific patients or provisions.
“They completely forgot that there are people dying,” the Right to Die Act.
One of the biggest complaints, critics say, is that the rule will delay or block access for patients medically seeking assisted suicide or hospice care. Many of the comments, including nearly 10,000 delivered directly to the DEA office, came from doctors and patients protesting the effect of the rule on critically ill and dying patients.
Linda Bleustein, 75, of Bridgeport, Connecticut, wrote: “Please don’t make the end of your life suffer any longer.” In March, Brustein, who has terminal fallopian tube cancer, reached a settlement. Vermont allows her to be the first nonresident to use the Medical Assisted Suicide Act. By the time she is ready to use her medicine, she expects she will be too sick to travel to see a doctor in person to get her prescription, she wrote. rice field.
A clash between desperate patients in need of care and the DEA’s efforts to stop telemedicine companies from over-prescribing dangerous drugs was inevitable, said David, a drug historian at the University of Buffalo. Herzberg said.
“The act of balancing is very tricky,” he said.
Laws in 10 states and Washington, DC allow dying people with a prognosis of six months or less to end their lives with lethal combinations of drugs covered by the DEA rule. However, such patients are often too sick to see a doctor directly. Alternatively, he lives hundreds of miles away from the qualified healthcare provider he wants, Shavelson says.
The 1.7 million Medicare beneficiaries enrolled in hospice care in the United States have similar problems, said Judi Lund Person, who oversees regulatory compliance for the National Hospice and Palliative Care Organization. Reducing the flexibility of online prescribing could mean dying patients waiting days for drugs to relieve pain and other symptoms.
“They don’t have time for that,” she said.
Schaverson and his colleagues sought an exception to the rule for the hundreds of patients each year who qualify for medically assisted suicide. Both the American Medical Association and the California Medical Association receive hospice or palliative care. I sent a letter to the DEA asking it to create a prescription for doctors who prescribe the most dangerous categories of drugs to their patients.
“These patients are highly vulnerable and their medical conditions do not allow for easy access to clinics,” wrote Donaldo D. Hernandez, Ph.D., president of California Group. Such people are said to be at “low risk of abuse” given their clear need for drug therapy.
Congress directed the DEA in 2008 to make an exception to allow remote prescribing for certain providers, but the agency didn’t, says Virginia Democratic Senator Mark Warner. statement last month.
DEA officials have not yet decided whether the COVID-19 telemedicine exemption will remain in effect if the proposed rule is not finalized by May 11, or whether the agency will allow teleprescribing exceptions. Didn’t answer the question.
Prescriptions for medical assisted suicide have increased significantly during the pandemic, in some cases. For example, in Oregon, he increased nearly 49% from 290 in 2019 to 432 in 2022. The number of deaths under law in the state also increased from 170 to 246. Nationally, at least 1,300 people die each year from using medical devices. Process, according to available state figures.
Telemedicine has been key to access during the COVID emergency, said Dr. Robin Plummer, the New Jersey doctor who prescribed the medication Terry Sheridan took. Plumer has overseen 80 assisted suicide deaths since 2020. Without online prescribing, her 35% to her 40% of her patients would have had no access to the law.
“I feel like we’ve been teaching people over the last few years that telemedicine works in so many areas and that it’s going to be a huge improvement for people,” he said, especially those at home and those dying. For those who are
“And what?” she said. “Are you going to pull me out all of a sudden?”
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The Associated Press’ Health Sciences Division is supported by the Scientific and Educational Media Group at the Howard Hughes Medical Institute. AP is solely responsible for all content.
