Tele-Buprenorphine Initiations for Opioid Use Disorder Without In-Person Relationships

In response to the COVID-19 pandemic, the US Drug Enforcement Administration (DEA) temporary telehealth rules waived the Ryan Haight Act requirement that clinicians examine a patient in person prior to prescribing a controlled substance.This March 16, 2020, change facilitated increased tele-initiation of buprenorphine, a lifesaving but underused medication for opioid use disorder (OUD). After the temporary telehealth rules expire on December 31, 2025,the DEA’s proposed rule for tele-prescribing thereafter requires an in-person visit with the buprenorphine-initiating clinician prior to or within 30 days of tele-initiation.To understand the proposed rule’s potential impact on buprenorphine initiations, we assessed the proportion of tele-initiations that did not meet these proposed in-person requirements from 2020 to 2022.