Federal officials said Friday that health care providers could prescribe medications for opioid addiction and ADHD via telehealth for another year, ending a months-long standoff between policymakers.

During the pandemic, the Drug Enforcement Agency issued temporary rules allowing providers to prescribe controlled substances like buprenorphine and Adderall without first meeting with a patient in person. These rules were set to expire on January 1 and have now been extended until the end of 2025. This extension propels to the second the resolution of a years-long debate – which has already generated almost 40,000 comments on the previously proposed rules . The Trump administration and leadership of the agency remain to be determined.

Pandemic-related flexibilities have paved the way for a broader debate about the strict rules that some say hinder access to potentially life-saving treatments. It also proved a boon for telehealth companies that emerged to provide care under the relaxed regime.

In 2023, the DEA issued draft rules aimed at reinstating restrictions criticized by telehealth advocates and providers, and last October it extended the flexibilities through the end of this year. The DEA has failed to meet its commitment to issue final rules by this fall, which one former official attributed to interagency conflicts and politics. The most recent draft rules released included numerous restrictions, including requiring that half of a provider’s controlled substance prescriptions be written for patients seen in person, and that providers check their patients against drug programs. prescription drug monitoring in all 50 states.

When these restrictions were disclosed, telehealth companies complained that they were untenable and would require the closure of a number of services. It has appeared for several months that the DEA would need to expand pandemic-related rules because the agency did not have enough time to issue finalized rules before the end of the year.

Many view these circulated regulations as an indictment of companies that overprescribe stimulants for profit; in June of this year, executives of the ADHD-focused telehealth company Do were arrested on suspicion of participating in an online controlled substance distribution scheme. By limiting the extension to just one year, the temporary rule says, it aims to “avoid encouraging investments necessary for the development of new telemedicine companies that could encourage or enable problematic prescribing practices.”

Companies and telehealth advocates agreed on the need for oversight to prevent fraudulent and harmful prescriptions that could lead to diversion, but many feared it would reverse progress made in treating drug addiction. opioids. Companies prescribing buprenorphine online were particularly vocal advocates for maintaining protections for telehealth addiction care.

The temporary rule also cited the “urgent public health need for continued access to buprenorphine as a medication for opioid use disorder” as motivation for the extension. While proponents of buprenorphine access celebrate the expansion, “this is still a temporary measure, and therefore insufficient from our perspective,” said Stephanie Strong, CEO and founder of the buprenorphine access company. addiction telemedicine Boulder Care. “Telehealth is not just a new thing or a stopgap measure. It’s a necessity. »

The expansion resolves one of several telehealth policies expiring at the end of the year. Congress is currently considering legislation that would extend for two years the rules allowing Medicare enrollees to receive a wide range of services via telehealth.