Prof. Benjamin A. Barsky Discusses Legal Barriers to Opioid Addiction Treatment

a headshot photo of Benjamin Barsky in a blue sweater with eyeglasses and a mustache.

Professor Benjamin A. Barsky discusses his research on health policy and addiction treatment.

 

Faculty Who Lead: Benjamin A. Barsky

  • Professor Benjamin A. Barsky studies how telemedicine rules affect access to treatment for opioid use disorder.
  • He explores how barriers beyond telemedicine restrictions can prevent some patients from receiving care.
  • Barsky outlines law and policy actions needed to improve health outcomes for vulnerable populations.

 

Professor Benjamin A. Barsky studies how health and criminal law affect historically marginalized populations. One key area of his research explores how controlled substance law and policy impacts health care access for people who use drugs such as opioids. His research shows that COVID-19-era rules, such as telemedicine expansions, improved treatment access for many patients with opioid use disorder (OUD), but not everyone benefited equally from these changes. Barsky describes his work as “highlighting how overlapping systems — including criminalization, federalism, and technology — shape health inequality in the U.S.”

Q: How do telemedicine rules affect patients seeking treatment for opioid use disorder? 

A: The COVID-19 pandemic changed the entire regulatory landscape surrounding the use of telemedicine for the treatment of OUD. Before the pandemic, clinicians were generally prohibited under federal law from initiating OUD treatment via telemedicine. They had to see patients in person first. During the pandemic, by contrast, the federal regulatory landscape changed completely: Clinicians were authorized to prescribe medications for opioid use disorder, namely buprenorphine, without conducting an in-person medical evaluation. This change unlocked a new treatment pathway for patients, including those who could not readily see a doctor in person. That said, time will tell what specific new regulatory changes will be applied to prescribing via telemedicine. The area remains in flux and actively contested.

Q: What other factors can affect one’s access to treatment? 

A: A variety of factors shape whether patients can get treatment via telemedicine. One is whether patients even have the technology that is necessary to see a prescriber. Another is ease of access to pharmacies that stock the right medicines. Still another is the existence of state-level restrictions on tele-prescribing. My research has shown that many states imposed their own restrictions on telemedicine after the federal rules became more flexible. These factors are among a constellation of barriers to care that have hindered the efficacy of telemedicine for the treatment of OUD.

Q: What solutions does your research suggest for expanding access to care? 

A: One is the expansion of telemedicine for the treatment of OUD or other substance use disorders, which requires changes at multiple levels. Clinicians and health care organizations must become comfortable using this modality if it can help them offer better care to their patients. Government bodies must also find ways to facilitate the use of telemedicine in this area, including by minimizing restrictions and providing incentives for its use. Importantly, these changes must be part of a much broader agenda for law, policy, and social change that confronts the criminalization and marginalization of drug use.

Q: What sparked your interest in researching this subject?

A: I am interested in identifying when and how criminal law shapes human health. This topic is directly relevant to this line of research. Finding ways to ensure that people with such health conditions get the care they need, rather than potentially being the subject of criminal control or regulation, is one of the goals of my work.

 

Find links to some of Barsky’s scholarly publications on this topic below: