The U.S. Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS) have extended pandemic-era telehealth flexibilities until December 2024, offering a critical lifeline to patients and providers who rely on remote care. This decision dramatically prolongs the window for developing permanent rules around the use of telehealth for prescribing controlled substances—especially important for those delivering telehealth for addiction recovery.
On October 6, 2023, the DEA announced a second temporary rule that preserves the status quo while it works on establishing long-term guidelines. The agency stated that the purpose of this extension is to ensure a smooth transition for patients and providers and to allow time to consider the public feedback received during its comment period and September listening sessions.
Why the Extension Matters
During the COVID-19 public health emergency, federal agencies temporarily relaxed restrictions on telemedicine. These changes allowed providers to offer a wide range of services remotely, including prescribing controlled substances without requiring an initial in-person visit. This flexibility proved especially valuable for behavioral health professionals and programs offering telehealth for addiction recovery, many of whom saw expanded access and improved patient outcomes.
The temporary rule now in place gives those providers an additional year to continue operating under the more lenient COVID-era policies. For patients receiving medication-assisted treatment (MAT) for substance use disorders—such as buprenorphine or methadone—the extension ensures continued access without disruption. It also gives providers time to adjust to whatever long-term framework the DEA eventually puts in place.
DEA’s Deliberation Process
In March 2023, the DEA released two proposed rules that would roll back many of the pandemic’s telehealth allowances. The rules reinstated requirements for in-person visits before prescribing medications listed in Schedules II through V, sparking a massive wave of backlash. The DEA received tens of thousands of public comments—most of them critical. In response, the agency delayed the implementation of those rules, hosted two days of listening sessions in September, and is now planning to issue new regulations in the fall of 2024.
These listening sessions included 11 hours of presentations from stakeholders who emphasized the value and safety of telehealth for addiction recovery. The DEA signaled it is open to revisiting the idea of a special registration process, which would allow certain providers to continue prescribing controlled substances via telehealth without requiring an in-person evaluation.
This marks a notable shift. Historically, the DEA has been slow to act on Congressional directives to create such a system. Now, public pressure, evolving treatment models, and bipartisan support appear to be driving change.
Balancing Access with Accountability
While the extension is good news for many providers and patients, it also reflects the DEA’s attempt to balance access with oversight. The agency is cautious about enabling problematic prescribing practices, especially in light of past controversies involving telehealth companies such as Cerebral and Done Global, which were scrutinized for allegedly overprescribing ADHD medications and other controlled substances.
To prevent further abuse while continuing to support legitimate care, the DEA’s temporary rule is time-limited. The agency made it clear that the goal is not to encourage a surge in telemedicine startups, but rather to give existing providers—particularly those offering telehealth for addiction recovery—the time and guidance needed to comply with future regulations.
What Comes Next?
The DEA’s final rule, expected by fall 2024, will likely define the future landscape for telehealth in behavioral health and addiction treatment. In the meantime, the current extension provides vital stability. Providers can continue delivering telehealth for addiction recovery without sudden operational changes, and patients can maintain consistent access to life-saving care.
This also opens the door for treatment centers and clinicians to invest in refining their virtual care models. Whether it’s improving technology, increasing staff training, or enhancing patient engagement tools, now is the time to prepare for what comes next.
The Bottom Line
The extension of COVID-era telehealth flexibilities is a win for both providers and patients. As the DEA and HHS work toward a final rule, those offering telehealth for addiction recovery have a critical opportunity to advocate for systems that prioritize both access and safety.
For patients in recovery, consistency and convenience matter. And for providers, having the ability to deliver services remotely has transformed the reach and impact of their care. As the healthcare landscape evolves, telehealth for addiction recovery continues to prove it’s more than a stopgap—it’s a vital component of modern treatment.
If your program uses telehealth for addiction recovery, now is the time to optimize your systems and ensure compliance with current standards while preparing for future changes. The road ahead may still have questions, but for now, patients and providers can breathe a sigh of relief—and keep moving forward.
