March 10, 2025
Area(s) of Interest:
Health Information Technology Drug Prescribing/Dispensing
What You Need to Know: The DEA has expanded the circumstances under which physicians can prescribe controlled substances for opioid use disorder via telemedicine.
The U.S. Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Services Administration jointly published a final rule on Jan. 17, 2025, expanding the circumstances under which physicians can prescribe schedule III-V controlled substances—such as buprenorphine—for the treatment of opioid use disorder via telemedicine, including audio-only telemedicine encounters.
The final rule makes several improvements that the California Medical Association (CMA) and American Medical Association (AMA) had recommended in response to the 2023 proposed rule. For example, while the proposed rule would only have allowed patients to be prescribed a 30-day supply of buprenorphine without an in-person visit, the final rule allows physicians to prescribe an initial six-month supply of such medications (split amongst several prescriptions totaling six calendar months) based on audio-only telehealth visits. To continue the prescription beyond 6 months, the physician can conduct an audio-visual or in-person evaluation. In addition, the final rule removes special recordkeeping and documentation requirements that CMA had opposed.
The final rule also clarifies that no action will be taken by the federal government against any party for not including buprenorphine products in suspicious order reporting. AMA had requested this clarification due to reports that distributors are delaying or suspending orders of buprenorphine because of fear that they will be investigated by the DEA. This has caused patients with opioid use disorder to suffer delays and denials of care—situations that cause harm and could lead to tragedy.
This regulation does not affect physician-patient relationships in cases where an in-person medical evaluation has previously occurred.
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