Risks of Improper Stimulant Prescribing With Telemedicine-Only Platforms

Recently, healthcare providers adopted telemedicine as a means to remotely grant access to patients seeking treatment for attention-deficit/hyperactivity disorder (ADHD). Two significant changes occurred during COVID-19 that facilitated the growth of telemedicine and the emergence of direct-to-consumer telemedicine-only corporations treating mental health conditions. First, the Drug Enforcement Administration issued a temporary rule suspending the requirement that providers conduct an in-person exam of patients before prescribing controlled substances. Second, states began to modify their licensing requirements, allowing providers to treat patients residing in other states. This article provides an overview of laws governing telemedicine, including prescribing requirements, licensing, and variations in prescription drug monitoring programs. Telehealth-only corporations raise new considerations for how to ensure quality and safety, guard against stimulant misuse, and prevent diversion. This article also explains two potential legal consequences for improper or excessive prescribing, including administrative sanctions by state medical boards and two recent cases of criminal liability.