The DEA’s Proposed Rules: Creating Barriers Instead of Solutions

The DEA’s proposed telehealth rules have sparked concern among mental health professionals, patients, and advocates. While the stated goal is to curb misuse and over prescription, these new restrictions threaten to undermine legitimate psychiatric care. Instead of addressing the real issues, such as lack of comprehensive assessment and inconsistent diagnostic practices, the proposed rules create arbitrary barriers that fail to help either patients or providers.

At MindMetrix, we believe that comprehensive psychiatric assessment should be an integral part of treatment. The answer to concerns about controlled substances is not to impose rigid, one-size-fits-all rules but to develop thoughtful, evidence-based guidelines that support both patients and providers. Many public comments on the DEA’s proposal highlight the need for structured assessments rather than restrictive policies.

The case for comprehensive evaluation

A more effective approach to prescribing controlled substances, especially for conditions like ADHD, would involve standardized assessments. As one commenter pointed out:

“It would make more sense to require more frequent meetings, pre-prescribing psychological testing, and psychometric testing for ADHD to further establish evidence for the diagnosis.”

Currently, the process for diagnosing ADHD and other conditions varies widely. Some providers rely on thorough evaluations, including structured testing and input from teachers or family members, while others rely on self-reports with little objective data. This inconsistency contributes to both underdiagnosis and overprescription. Standardizing diagnostic processes would improve treatment accuracy and prevent misuse without limiting access for those who genuinely need care.

Telehealth and the double standard

The DEA’s proposed restrictions also disproportionately impact telehealth patients, despite evidence that telehealth providers often exercise more caution in prescribing than in-person providers. One practitioner shared:

“I have patients that I treat via telehealth with schedule 2-5 medications that have been fully assessed and their diagnosis supports their treatment. I have clients with in-person providers that just ‘give away’ controlled substances freely. Just yesterday, I had a patient that just ‘told’ his PCP that he had ADHD in the past and was given a prescription for Adderall. The patient advised that the PCP did not assess him nor was there any testing to confirm his diagnosis.”

If the goal is to reduce inappropriate prescribing, then policy efforts should focus on improving diagnostic standards across all forms of care—not punishing telehealth providers who are already employing rigorous assessment methods.

The risks of shortened appointments and infrequent follow-ups

Another key concern is that increased restrictions on prescribing will lead to shorter appointment times and infrequent follow-ups, which will compromise diagnostic accuracy and patient safety. One commenter emphasized:

“Shorter appointment times and infrequent follow-ups will compromise thorough diagnostic evaluations. Critical screenings for co-existing conditions—present in 80% of adults with ADHD—will be reduced or missed entirely. Providers will find it increasingly difficult to maintain continuity of care while adhering to rigid Rx restrictions during both in-person and telehealth visits.”

Restrictive policies often have unintended consequences. By making it harder for patients to access the care they need, these rules could actually drive more individuals to seek prescriptions from less responsible providers or attempt to self-medicate.

A better path forward

Instead of implementing rigid policies that fail to differentiate between responsible and irresponsible prescribing, the DEA should focus on creating standardized, evidence-based diagnostic guidelines. As one public commenter suggested:

“Standardize the diagnosis process for ADHD. There is a lot of variability in how it’s currently approached. A more uniform process including questionnaires, diagnostic tools, and guidelines could ensure that individuals who truly need treatment receive it and that treatment is appropriate.”

By promoting comprehensive assessments, frequent follow-ups, and the use of objective diagnostic tools, we can ensure that those who need treatment receive it—while reducing the risk of misuse.

The DEA’s proposed rules are a step in the wrong direction. Instead of making care harder to access, we should be making it more precise and effective. At MindMetrix, we advocate for policies that support patient well-being by emphasizing thorough assessments and responsible prescribing practices.

It’s time for policymakers to move away from arbitrary restrictions and toward meaningful reform that actually helps those who need it most. Thoughtful, evidence-based policies—not bureaucratic barriers—are the key to responsible psychiatric care.