DEA extends telemedicine prescribing of controlled substances, for now.

[Nelson Vergel]

Thanks to the tens of thousands of public comments (over 38,000) submitted by concerned citizens, the DEA will be extending the current rules, first passed as part of the COVID-19 emergency, that have made healthcare more accessible.

DEA seeks to temporarily extend virtual prescribing for controlled substances​

Statement from the DEA Administrator Anne Milgram on COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications

The Drug Enforcement Administration received a record 38,000 comments on its proposed telemedicine rules. We take those comments seriously and are considering them carefully. We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have...

www.dea.gov

May 03, 2023
DEA Administrator
"The Drug Enforcement Administration received a record 38,000 comments on its proposed telemedicine rules. We take those comments seriously and are considering them carefully. We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities while we work to find a way forward to give Americans that access with appropriate safeguards.

For this reason, last week, DEA, in concert with the Department of Health and Human Services, submitted a draft Temporary Rule to the Office of Management and Budget entitled “Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications.” Further details about the rule will become public after its full publication in the Federal Register."

 

[Nelson Vergel]

We await to see what this document will contain:

Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications

 

[AndrogenHacker]

Thank God. Thanks for the update. Good work gentleman.

 

[tmaxey1]

I read somewhere that mental health lobby came in and had testimony at the hearing that swayed this. If you check the DEA website and look at who was given a voice it is telling. The trt community may not have had any impact on the decisions. Like everything with our government, which ever position has the most money behind it gets what it wants.

 

[Nelson Vergel]

The trt community may not have had any impact on the decisions.

You can search for keywords in the comments. Regulations.gov

Testosterone keyword: 6,424 results

TRT keyword: 2,013 results

Pain: 9,137 results

Transgender: 1,285 results

Trans men: 167 results

ADHD: 2,043 results

Opiates: 466 results

Women: 493 results

Rural: 3,662 results

Mental health: 3,246 results

Veterans: 327 results

HRT: 643 results

Gender affirming: 638 results

Access: 18,934 results

Compounding pharmacies: 73 results

Patient care: 14,994 results

Addiction: 1,505 results

 

[tmaxey1]

Over 30% of comments came from the TRT community (men, women, and transmen). Others from pain management and end-of-life advocates. You can search keywords in the comments:

Understood. I can't find the agenda for the meeting any longer where they had doctors and other speakers who came to voice their concern for the rule change. I just remember when I did see it thinking all the speakers who had a voice in the room were from lobby groups representing mental health and addiction industry. I'm not sure if any of the speakers who had the ear of the DEA were TRT specific or if the other industries bought a seat at the table and we also benefited.

 

[Nomad]

Honestly confused. Been using Defy for like 5 years now… a couple years before covid. So, how did covid enable me to receive something, I was already receiving?

Testosterone has been the only reliable medication my pharmacy(expressscripts) has, pregnyl (HCG) is still hard to acquire unless Defy calls another pharmacy which is another 30.00 fee, which does add up in this economy.

 

[Dicky]

Honestly confused. Been using Defy for like 5 years now… a couple years before covid. So, how did covid enable me to receive something, I was already receiving?

Testosterone has been the only reliable medication my pharmacy(expressscripts) has, pregnyl (HCG) is still hard to acquire unless Defy calls another pharmacy which is another 30.00 fee, which does add up in this economy.

The way I understand it is that with covid, the DEA started allowing telemed providers to start prescribing stuff like opiates and ADHD meds, whereas before they weren't. These are controlled substances as is testosterone. When the emergency measures ended testosterone therapy got included in the discussion of rolling back telemed access to these meds. That's how I understand it.

The cynic in me thinks that the DEA has been wanting to limit testosterone access for many years and that this occasion was just the excuse they needed to make it happen.

 

[Nelson Vergel]

Please read:

THE DEA And ACCESS TO TRT TELEMEDICINE

COMMENTS DUE DATE: MARCH 31. THE DEA WANTS TO LIMIT YOUR ACCESS TO TELEMEDICINE EXECUTIVE SUMMARY: The DEA has proposed new rules to update the Ryan Haight Act, which could negatively affect telemedicine prescribing of non-narcotic medications in Schedules III, IV, and V. These rules would...

www.excelmale.com

Before and during COVID, there was no written policy from the DEA about requiring a in person visit to get prescribed testosterone. The proposed rule would not only require that, but also require for the local doctor or provider that does the physical exam required by Defy and other telemeds to also have a DEA license and for the telemedicine doc to watch your local physical by video. It would also require for the doctor that does the physical to keep tabs on any treatment change.

It was not clear to me if existing patients would be grandfathered in. But I had the impression that the rule would apply to existing and new patients.

If that is the case, you would have to fly to Tampa.

You could also not get more than a 30 day supply for refills.

 

[paralyzer]

"Before and during COVID, there was no written policy from the DEA about requiring a in person visit to get prescribed testosterone." -

With all due respect, that is not true. Testosterone is classified as a control - the DEA rules (Ryan Haight Act) before Covid dictated that you have to be seen in-person, by a licensed practitioner, in order to be prescribed a controlled substance. However, the DEA was quite lax about enforcing this, leading to the telemed providers who would satisfy the rule by having you get a letter signed by an urgent-care doctor or PCP.

If you read the law, such letter signatures probably do not qualify. My personal opinion is that the DEA didn't really realize that this 'loophole' was proliferating so largely.

 

[Vin]

Honestly confused. Been using Defy for like 5 years now… a couple years before covid. So, how did covid enable me to receive something, I was already receiving?

Testosterone has been the only reliable medication my pharmacy(expressscripts) has, pregnyl (HCG) is still hard to acquire unless Defy calls another pharmacy which is another 30.00 fee, which does add up in this economy.

 

[Vin]

Honestly confused. Been using Defy for like 5 years now… a couple years before covid. So, how did covid enable me to receive something, I was already receiving?

Testosterone has been the only reliable medication my pharmacy(expressscripts) has, pregnyl (HCG) is still hard to acquire unless Defy calls another pharmacy which is another 30.00 fee, which does add up in this economy.

Agree with you.. Also in the same boat.. was receiving Trt through defy before the Covid deal where telemedicine was utilized much more etc.. many were already receiving all the same benefits pre Covid.. hopefully it resolves to the benefits of many of us who rely on it… and listen to the many it helps

 

[Nomad]

Agree with you.. Also in the same boat.. was receiving Trt through defy before the Covid deal where telemedicine was utilized much more etc.. many were already receiving all the same benefits pre Covid.. hopefully it resolves to the benefits of many of us who rely on it… and listen to the many it helps

Yeah man. This time around my pharmacy (expressscripts) is being a pain the ass delaying for defy to call them because the testosterone supposedly has potential to interact with metformin both of which I’ve been on for years. So, I’m out of meds for at least a week now

 

[Vin]

Yeah man. This time around my pharmacy (expressscripts) is being a pain the ass delaying for defy to call them because the testosterone supposedly has potential to interact with metformin both of which I’ve been on for years. So, I’m out of meds for at least a week now

I also take metformin.. I haven’t heard of it interacting with testosterone.. only thing I’ve heard of with metformin is it can lower someone’s natural testosterone (not someone on trt, as far as I’ve heard) what did you hear with regards to this? Hope that they don’t slow down your meds brother

 

[Nomad]

I also take metformin.. I haven’t heard of it interacting with testosterone.. only thing I’ve heard of with metformin is it can lower someone’s natural testosterone (not someone on trt, as far as I’ve heard) what did you hear with regards to this? Hope that they don’t slow down your meds brother

I’m honestly confused what’s going. It said on expressScripts site the interaction thing. But, deft contacted me saying the pharmacy wanted a copy of my medical records

If the pharmacy starts limiting meds like this I’ll have to switch to Amazon pharmacy and have to start paying.

I’m on 200mg test c, 100units HCG, aromasin, Lipitor, sertraline, and metformin age 38. Minor heart attack in January (suspected blood clot) had every test imaginable done and the cardiologist said he can’t say there’s 0 percent chance of me being at risk for another heart attack but he’d say less than 1%

Had a physical back in February

My hematocrit is checked every 60 days and phlebotomy performed anytime it’s over 45

As far as I know I’m doing everything the right way.

 

[Vin]

I’m honestly confused what’s going. It said on expressScripts site the interaction thing. But, deft contacted me saying the pharmacy wanted a copy of my medical records

If the pharmacy starts limiting meds like this I’ll have to switch to Amazon pharmacy and have to start paying.

I’m on 200mg test c, 100units HCG, aromasin, Lipitor, sertraline, and metformin age 38. Minor heart attack in January (suspected blood clot) had every test imaginable done and the cardiologist said he can’t say there’s 0 percent chance of me being at risk for another heart attack but he’d say less than 1%

Had a physical back in February

My hematocrit is checked every 60 days and phlebotomy performed anytime it’s over 45

As far as I know I’m doing everything the right way.

Well it does look like you are doing what you need to in order to keep things in good standing.,

 

[Pacman]

What is the latest on this? I haven't been here for a few months and I cannot seem to find the original thread.

What has the DEA decided and what are the guidelines moving forward?

Does anyone have any contingency plans in place?

 

[tareload]

original thread.

Wow first it was closed and now it is gone. What an epic waste of time posting for it to all go up in smoke. Duly noted.

Good luck.

 

[Cataceous]

Wow first it was closed and now it is gone. What an epic waste of time posting for it to all go up in smoke. Duly noted.
...

A small consolation is that Nelson did a soft delete, so the thread is still visible to moderators. It would be helpful to have an explanation.

 

[Nelson Vergel]

Until Dec 31, 2024

Regulations.gov

www.regulations.gov