The Drug Enforcement Administration (DEA) delivered providers of substance use disorder (SUD) care a year-end gift that officially extends telehealth prescribing flexibilities around controlled medications like methadone, naltrexone and buprenorphine through Dec. 2026.

While the extension has been anticipated since early November after a pending executive order was sent to the Office of Management and Budget hinting at the agency’s intention to extend the prescribing provisions, the DEA officially announced the news on Dec. 31.

Though the deadline for a final decision on the rule’s future was slated for today, some have criticized the government for allowing the decision-making to be left for the last minute, which “created avoidable uncertainty,” across the industry and “came within hours of expiration, placing patients, providers, and health systems on the brink of unnecessary disruption,” Alexis Apple, deputy executive director, the American Telemedicine Association (ATA) Action and vice president of federal affairs at the ATA said in a statement.

The extension marks the fourth year that these COVID-19-era flexibilities have been extended. 

Under the renewed rules, practitioners are permitted to prescribe Schedule II-V narcotic medications that are FDA-approved “for maintenance and withdrawal management treatment of opioid use disorder via audio-only telemedicine encounters, without having ever conducted an in-person medical evaluation,” according to a press release.

The extension enables continuity of care for patients with SUDs and broadens access to care and medication-assisted treatments for individuals in rural areas.

The rule will take effect Jan. 1, 2026 and expire Dec. 31, 2026, according to the Federal Register.

Previous telehealth prescribing extensions brought relief and ease to many providers, allowing them to more easily prescribe controlled medications for SUD treatment with fewer barriers, which “has proven to be a lifeline for patients by expanding access to care, reducing treatment delays, and improving outcomes,” Apple said.

The renewed extension is still a temporary fix. Many in the industry have called for a permanent framework to replace annual deadlines for the rule’s renewal, but to no avail.

“This critically important waiver must be preserved continuously until a permanent policy is enacted. …,” Apple said. “We continue to support a permanent Special Registration framework that enables responsible patient care and equips the DEA with appropriate tools to prevent misuse.”

In its announcement, the DEA acknowledged the value of the extension and noted the agency “recognizes that the expiration of the current telemedicine flexibilities without further regulation could disrupt patient care.”

The agency seems poised to work toward a finalized, more permanent framework during the year ahead, noting that the latest extension will allow it “time to finalize and implement regulations that balance access to care with the necessary safeguards against drug diversion.”

The ATA and other industry and federal stakeholders are also working toward that aim.

“Beginning in January, we will double down on our efforts to make all temporary telehealth waivers permanent or at least extended multiple years to avoid any lapses in telehealth services in the future,” Apple said.