Prescribing Controlled Substances When Using Telepsychiatry

In this installment of "Your Questions Answered," Psych Congress Steering Committee member Edward Kaftarian, MD, responds to a question asked at a Psych Congress 2020 session he presented on telepsychiatry. Dr. Kaftarian is CEO of Orbit Health Telepsychiatry, Encino, California, a member of the American Psychiatric Association’s Telepsychiatry Committee, and former vice chair of mental health for the American Telemedicine Association.

Q: How does one navigate the federal limitation on prescribing controlled substances if a patient is not in an authorized health care setting?   

A: Fortunately, on March 16, 2020, the Drug Enforcement Administration (DEA) announced that due to the COVID-19 public health emergency, DEA-registered practitioners are permitted to prescribe Schedule II-V controlled substances to patients without first conducting an in-person medical evaluation, provided that the prescription is for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice, telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system, and the practitioner is acting in accordance with applicable federal and state law.

This is a temporary authorization and is one of the exceptions to the in-person rule of the Ryan Haight Act. It is recommended that providers keep abreast of any updates, especially when the COVID-19 pandemic begins to wane. Also, providers are advised to check their state laws.

Another exception to the in-person rule of the Ryan Haight Act is that the provider has obtained a special registration to practice telemedicine. Unfortunately, the DEA has not yet established the special registration process for telemedicine. We are hoping that this will happen soon and there is considerable public pressure for the DEA to do that

Read more on telepsychiatry:
A Q&A With Dr. Edward Kaftarian on Telepsychiatry
Using Telehealth to Treat Adults With Cognitive Impairment
Transition to Virtual Mental Health Care Occurred Rapidly in Pandemic’s Early Weeks
Telepsychiatry Program Increases Rate of ED Discharges to Home