With telehealth in limbo, Ohio patients worry about access to some controlled medications

The COVID-19 public health emergency ending has left Ohioans who are prescribed controlled substances in limbo.

Telehealth cut down Alicia Hopkins’ commute to and from her psychiatrist from seven hours to just a few turns to her computer.

“I’m a wheelchair user, so I rely on paratransit,” Hopkins said. “But if I would have to travel long distance, that’s several hundred dollars for a van to go to Cleveland from where I live.”

She has bradycardia, a heart rate that’s too slow, and also ADHD.

“Before getting on Concerta, my life was one hospitalization after another,” she added.

Concerta is a stimulant, similar to Adderall and Vyvanse. It is also a controlled medication, as are other stimulants, opioids, depressants, hallucinogens and anabolic steroids.

In the past few years, Hopkins’ health has stabilized, helped in part because the COVID-19 public health emergency loosened regulations around telehealth. This allowed practitioners to prescribe controlled substances using telemedicine.

“That has helped a lot of folks access services that they wouldn’t have otherwise been able to fit into their lives in the midst of it,” Psychiatrist Dr. Christina Weston said.

Patient care may get much more difficult, Weston warned. Last week, the COVID emergency ended, throwing telehealth into limbo.

“It’s going to pose additional barriers to folks, not just folks with ADHD stimulants, but also opioid use disorders,” the doctor said.

The Drug Enforcement Administration just put a temporary hold on telehealth changes until November, while they read testimony about the rules they are proposing to put in place of it. There is more flexibility for already-established relationships, as well. If a doctor’s relationship is established with the patient before November 11, 2023, the full set of COVID telemedicine flexibilities will be extended for one year, or through November 11, 2024.

For Weston, and for many telehealth patients, continuing to allow for flexibility in health care is essential.

“It’s going to make that a little harder for them, especially in areas where there aren’t enough providers,” Weston added.

But some are skeptical. In a previous OCJ/WEWS story, some business experts alleged that new companies were allowing patients to get prescribed easier.

“Since the pandemic, we saw that entry into the market of Telehealth start-ups,” said Juscelino Colares, law and business professor at Case Western Reserve University.

Hopkins says she has looked for years, and can’t find anyone local who specializes in her illness and takes her insurance, plus there is already a shortage of psychiatric healthcare workers.

If Hopkins doesn’t have access to her medicine, the consequences could be dire, she said.

“I would probably end up in the hospital,” she said. “I would probably lose everything if I would have to go off this medicine.”

As of right now, Ohio law states that telehealth for controlled substances is only being allowed because of federal regulations. The State Medical Board did put forward new regulations at the end of February. The Telehealth Rules Document highlights the changes that have been implemented.

This article was originally published on News5Cleveland.com and is published in the Ohio Capital Journal under a content-sharing agreement. Unlike other OCJ articles, it is not available for free republication by other news outlets as it is owned by WEWS in Cleveland.

Follow WEWS statehouse reporter Morgan Trau on Twitter and Facebook.