APA’s Government, Policy, and Advocacy Update (November 2024)
APA Pushes for Extension of Teleprescribing for Controlled Medicines
To prevent increasing inequity and disruptions in care for patients, APA is calling on the Biden administration to push for a two-year extension of the current flexibilities that allow clinicians to prescribe controlled medications via telemedicine. Controlled substances are sometimes prescribed by psychiatrists to treat illnesses such as attention-deficit/hyperactivity disorder (ADHD), substance use disorder, insomnia, and anxiety.
The current flexibilities are slated to end in December 2024. Without a finalized rule or extension prior to December 31, “millions of individuals across the country are within weeks of losing access to their mental health and substance use treatment,” APA wrote in a letter to the White House. In an informal survey in spring 2023, 97% of more than 1,600 APA members reported conducting telehealth visits.
“Telemedicine has not been shown to increase diversion. Rather it decreases no-show rates and increases access to medically necessary care that considers the patient’s preferences,” APA wrote. “… Reducing flexibility in modalities of care increases inequity, forcing practitioners to cherry-pick patients that have the ability to travel to in-person care.”
A two-year extension would allow time for the Drug Enforcement Administration (DEA) to promulgate a new rule governing prescription of controlled medications and implement practice changes to prevent patient-care disruptions.
APA Seeks Solutions to Stimulant Shortages in Meeting With Feds
On behalf of APA, the chair of APA’s Council on Children, Adolescents, and Their Families pressed federal officials to take action on continued nationwide prescription stimulant shortages as part of a meeting with the Food and Drug Administration (FDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) in September.
Lisa R. Fortuna, M.D., M.P.H., along with APA partner organizations, spoke with FDA and SAMHSA officials about the shortages, their impacts on members and their patients, as well as how ADHD is diagnosed and treated. Several medications used to treat ADHD have been in short supply or unavailable for as long as two years.
To address the shortages, the DEA adjusted the 2024 production quota for the Schedule II stimulants and medication components lisdexamfetamine (from 26.5 million g to 32.7 million g) and d-amphetamine for conversion (from 20 million g to 23.7 million g), according to the Federal Register.
At the meeting, Fortuna also shared informal APA survey data with the FDA and SAMHSA showing that 99% of responding clinicians report that patients with ADHD are continuing to face challenges with the stimulant shortage, including delays of weeks or months in getting their prescriptions filled or not being able to obtain their medication.
APA Urges New Perinatal Mental Health Program for Military
APA along with dozens of other organizations have sent a letter to congressional leaders urging them to create a pilot program aimed at preventing perinatal mental health conditions in pregnant and postpartum members of the armed forces and their covered beneficiaries.
According to a report from the Government Accountability Office, military mothers experience maternal mental health conditions at two to three times the rate of their civilian counterparts. Maternal mental health conditions are also the most common complication of pregnancy, with suicide and overdose accounting for more than 22% of pregnancy-related deaths among all women.
The proposed program would be part of the National Defense Authorization Act and is based on the bipartisan Maintaining Our Obligation to Moms Who Serve Act. It would pilot evidence-based maternal mental health prevention programs at military treatment facilities—an approach that has been proven to prevent and lessen the severity of maternal mental health conditions and their symptoms, according to the letter.
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Psychiatric News
History
Published online: 21 October 2024
Published in print: November 1, 2024 – November 30, 2024
Keywords
- teleprescribing
- flexibilities
- telehealth
- telemedicine
- virtual
- telemental health
- controlled substances
- amphetamine
- d-amphetamine
- lisdexamfetamine
- stimulants
- Adderall
- Ritalin
- ADHD
- Attention-deficit/hyperactivity disorder
- diversion
- armed services
- Drug Enforcement Agency
- Council on Children, Adolescents, and their Families
- Lisa R. Fortuna
- Lisa Fortuna
- National Defense Authorization Act
- Maintaining Our Obligation to Moms who Serve Act
- MOMS Act
- maternal mental health
- postpartum
- pregnancy
- perinatal
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