Diversion Control Division, US Department of Justice, Drug Enforcement Administration

COVID-19 Information Page > COVID-19 FAQ

COVID-19 FAQ

Questions & Answers

Telemedicine

Question: Can telemedicine now be used under the conditions outlined in Title 21, United States Code (U.S.C.), Section 802(54)(D)?

Narcotic Treatment Program

Question: Can a narcotic treatment program (NTP) order and store additional amounts of methadone during the COVID-19 crisis where these additional quantities would not fit in the schedule II controlled substances safe?

Question: Can a narcotic treatment program (NTP) mail methadone to enrolled patients at their home using the U.S Postal Service?

National Drug Supply

Question: I’ve heard talk of methadone shortages during the pandemic. Are there possible threats of a methadone shortage as a result of the COVID-19 outbreak?

Prescriptions

Question: How do U.S. citizens in foreign countries, who cannot leave due to Covid-19, get their controlled substance medication from the United States?

Miscellaneous

Question: Does DEA have any recommendations for how health care systems should best deploy registrants that are at a high risk for infection during the COVID-19 health emergency?


Telemedicine

Question: Can telemedicine now be used under the conditions outlined in Title 21, United States Code (U.S.C.), Section 802(54)(D)?

Answer: Yes. While a prescription for a controlled substance issued by means of the Internet (including telemedicine) must generally be predicated on an in-person medical evaluation (21 U.S.C. 829(e)), the Controlled Substances Act contains certain exceptions to this requirement. One such exception occurs when the Secretary of Health and Human Services has declared a public health emergency under 42 U.S.C. 247d (section 319 of the Public Health Service Act), as set forth in 21 U.S.C. 802(54)(D). Secretary Azar declared such a public health emergency with regard to COVID-19 on January 31, 2020 (https://www.hhs.gov/about/news/2020/01/31/secretary-azar-declares-public-health-emergency-us-2019-novel-coronavirus.html). On March 16, 2020, the Secretary, with the concurrence of the Acting DEA Administrator, designated that the telemedicine allowance under section 802(54)(D) applies to all schedule II-V controlled substances in all areas of the United States. Accordingly, as of March 16, 2020, and continuing for as long as the Secretary’s designation of a public health emergency remains in effect, DEA-registered practitioners in all areas of the United States may issue prescriptions for all schedule II-V controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided all of the following conditions are met:

  • The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice;
  • The 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 laws.

Provided the practitioner satisfies the above requirements, the practitioner may issue the prescription using any of the methods of prescribing currently available and in the manner set forth in the DEA regulations. Thus, the practitioner may issue a prescription either electronically (for schedules II-V) or by calling in an emergency schedule II prescription to the pharmacy, or by calling in a schedule III-V prescription to the pharmacy.

The term "practitioner" in this context includes a physician, dentist, veterinarian, or other person licensed, registered, or otherwise permitted, by the United States or the jurisdiction in which s/he practices to prescribe controlled substances in the course of his/her professional practice (21 U.S.C. 802(21)).

Important note: If the prescribing practitioner has previously conducted an in-person medical evaluation of the patient, the practitioner may issue a prescription for a controlled substance after having communicated with the patient via telemedicine, or any other means, regardless of whether a public health emergency has been declared by the Secretary of Health and Human Services, so long as the prescription is issued for a legitimate medical purpose and the practitioner is acting in the usual course of his/her professional practice. In addition, for the prescription to be valid, the practitioner must comply with applicable Federal and State laws.

Narcotic Treatment Program (NTP)

Question: Can a narcotic treatment program (NTP) order and store additional amounts of methadone during the COVID-19 crisis where these additional quantities would not fit in the schedule II controlled substances safe?

Answer: Questions relating to the physical security of the handling of controlled substances need to be forwarded and addressed to your local DEA field office. The local DEA field office is directly responsible for the registrants in their area of responsibility. They will able to assist you relating to physical security issues. Contact your Local DEA Field Office for assistance. (DEA071 – March 22, 2020)

Question: Can a narcotic treatment program (NTP) mail methadone to enrolled patients at their home using the U.S Postal Service?

Answer: No – The Controlled Substances Act (CSA) generally permits the dispensing and delivery of controlled substances by mail from a DEA-registered pharmacy to a legitimate ultimate user pursuant to a valid prescription. However, the CSA and DEA regulations include additional controls for narcotic drugs used for maintenance or detoxification treatment. See 21 U.S.C. 823(g); 21 CFR 1301.28, 1301.74(i)-(l), 1306.07. Due to the high risk of diversion posed by maintenance or detoxification treatment using the schedule II narcotic methadone, DEA regulations provide that an NTP may not prescribe methadone for maintenance or detoxification treatment, and may only administer or dispense it directly to a narcotic dependent person for the purpose of maintenance or detoxification treatment. 21 CFR 1301.74(i), 1306.07.

Recently, in light of the public health emergency declared by the Secretary of Health and Human Services on January 31, 2020, DEA has waived some of the limitations regarding methadone dispensing for maintenance and detoxification treatment to ensure continued access during the COVID-19 (Coronavirus) emergency. At this time, DEA has authorized employees of the NTP to personally deliver methadone to patients who otherwise cannot travel to the NTP (DEA NTP Delivery Guidance). In addition, DEA has issued a waiver to permit law enforcement and National Guard personnel to deliver methadone directly to patients of NTPs (DEA NTP Delivery Guidance). However, it remains the assessment of the DEA Diversion Control Division that the potential for diversion and abuse of methadone for maintenance and detoxification treatment of narcotic dependent persons is too high to extend the waiver further to permit dispensing via the U.S. Postal Service or other common carriers. Thus, DEA’s regulations prohibiting such delivery have not been waived and remain in effect.

National Drug Supply

Question: I’ve heard talk of methadone shortages during the pandemic. Are there possible threats of a methadone shortage as a result of the COVID-19 outbreak?

Answer: DEA has no information at this time indicating there is a shortage of the methadone oral dosage forms used in maintenance and detoxification treatment of opioid use disorder as a result of the pandemic. Although FDA has indicated that injectable methadone hydrochloride is currently experiencing drug shortages, DEA does not foresee any issue with obtaining methadone oral tablets or oral solution during this public health emergency. Methadone is domestically manufactured and DEA routinely interacts with the manufacturers and the FDA to ensure there is no shortage of the raw materials to manufacture the oral dosage forms. For more information on drug shortages generally, including the current shortage of methadone HCl injection, please consult FDA's drug shortages website.

Prescriptions

Question: How do U.S. citizens in foreign countries, who cannot leave due to Covid-19, get their controlled substance medication from the United States?

Answer: Federal law and international treaties prohibit the exportation of controlled substances unless the exportation is made by a DEA registered exporter. Therefore, a U.S. citizen in a foreign country due to Covid-19 may only receive his/her medications from the United States if the medication is exported by a DEA registered exporter. In addition, a U.S. citizen may have to comply with applicable laws of the country into which the controlled substance is being imported. However, a U.S. citizen may also seek assistance from the United States Department of State, Office of Overseas Citizens Services, at 1-202-501-4444 from overseas or 1-888-407-4747 from the U.S. and visit the following Department of State Website.

Miscellaneous

Question: Does DEA have any recommendations for how health care systems should best deploy registrants that are at a high risk for infection during the COVID-19 health emergency?

Answer: Although DEA is concerned for the safety of all its registrants, we must defer any questions regarding safe medical practices to the Center for Disease Control. Also, listed at the end of this page are links to all 50 states medical boards, pharmacy boards, and emergency operations pages.

 


EO13891 Disclaimer: Guidance documents, like this document, are not binding and lack the force and effect of law, unless expressly authorized by statute or expressly incorporated into a contract, grant, or cooperative agreement. Consistent with Executive Order 13891 and the Office of Management and Budget implementing memoranda, the Department will not cite, use, or rely on any guidance document that is not accessible through the Department’s guidance portal, or similar guidance portals for other Executive Branch departments and agencies, except to establish historical facts. To the extent any guidance document sets out voluntary standards (e.g., recommended practices), compliance with those standards is voluntary, and noncompliance will not result in enforcement action. Guidance documents may be rescinded or modified in the Department’s complete discretion, consistent with applicable laws.

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