Changes To Treatment Regulations During And After The COVID-19 Public Health Emergency

The COVID-19 Public Health Emergency (PHE) necessitated policies that protected patients and providers while also maintaining uninterrupted access to services. Early in the pandemic, the Substance Abuse and Mental Health Services Administration (SAMHSA) promulgated treatment flexibilities that waived regulatory restrictions on unsupervised methadone take-home medication, and, in conjunction with the DEA, established permissions for the initiation of buprenorphine without an in-person examination. As the pandemic progressed and rates of overdose climbed, SAMHSA implemented policies that advanced harm reduction (fentanyl test strips) and expanded access to treatment (revisions to the buprenorphine practice guidelines and mobile medical units). Federal agencies are evaluating these policy changes to assess their safety and efficacy as part of considerations on whether to make these flexibilities permanent. This symposium will review the flexibilities and policies put in place during the PHE and discuss lessons learned from their implementation. The session will also consider the impact of the COVID-19 pandemic on communities across the United States and how this has contributed to a rise in overdose deaths and an urgent need to expand access to treatment. In doing so, presenters will discuss rates of substance and polysubstance misuse, and evidence-based interventions. The symposium will engage participants in discussion, particularly around how treatment flexibilities were implemented during the difficult, early months of the pandemic. This will also allow consideration of how the flexibilities and other policy initiatives may have benefitted providers and patients, while also inviting participants to consider issues that will extend beyond, or arise from the pandemic.