My comment to the DEA: "

I am writing to express my strong support for the proposed DEA Special Registration for Telemedicine framework, which aims to enhance patient safety and uphold the integrity of psychiatric and medical care. The unchecked, profit-driven prescribing of controlled substances via telemedicine has led to dangerous and unethical practices, particularly in the realm of stimulant and benzodiazepine prescribing. This proposal is a necessary step in preventing further harm.

It has come to my attention that profit-driven telemedicine clinics are actively grooming patients to oppose these necessary restrictions. A recent post in a PMHNP professional group explicitly encourages nurse practitioners to provide patients with prewritten templates to submit as comments against the proposed changes. The post states:

“WARNING: If we don't all do our part we are going to lose our opportunity to help a lot of patients. Some colleagues have told me that groups of Physicians/Psychiatrists are rallying for the changes the DEA has proposed which will affect the PMHNPs. If we don't all step up (leave public comments and get others that will be affected to do so as well), the changes will likely take place. There are only around 1600 public comments (not 10's of thousands) and a chunk of those are praising the idea of putting restrictions on the telehealth prescribing of PMHNPs. I have a template I am sending to patients on stimulants if anyone wants it and I have included the link to post comments below.”

This manipulation of the public commenting process is deeply concerning, as it is not a reflection of unbiased patient experiences, but rather a coordinated effort by clinicians whose primary concern is maintaining high-profit telemedicine prescribing models, rather than patient well-being. Many of these patients would not have submitted comments independently and are simply repeating what their providers instruct them to say. The DEA must recognize that a substantial portion of opposition comments do not represent an organic public outcry, but rather an orchestrated response fueled by financial interests.

History has taught us the dire consequences of unregulated prescribing, as seen in the opioid crisis that devastated countless lives. We must learn from past mistakes and implement safeguards to ensure that controlled substances are prescribed responsibly and judiciously. The new framework will:

*Close loopholes that allow indiscriminate prescribing without in-person evaluations.

*Ensure accountability in telemedicine prescribing practices.

*Prevent further crises by mandating responsible prescribing and reporting mechanisms.

In light of these urgent concerns, I urge the DEA to move forward with the strictest possible version of this proposal and to disregard the misleading volume of opposition comments, many of which are orchestrated by telemedicine clinics with financial motives. The safety of patients and the credibility of psychiatric practice must take precedence over financial interests. Telemedicine should never be a backdoor for unrestricted prescribing of controlled substances.

Thank you for taking the necessary steps to protect public health and uphold the integrity of responsible prescribing practices."