DEA Telemedicine Rules: What You Need to Know About Remote Prescribing

When it comes to getting prescriptions for controlled substances like opioids, stimulants, or sedatives over video calls, the DEA telemedicine rules, federal guidelines set by the Drug Enforcement Administration that control how doctors can prescribe controlled substances remotely. These rules determine whether a doctor can write a prescription for a narcotic without ever seeing you in person. Before 2020, you had to meet your doctor face-to-face at least once before getting any controlled substance via telehealth. That changed during the pandemic—emergency flexibilities let doctors prescribe remotely without an in-person visit. But those temporary rules expired, and now the DEA has put new, permanent rules in place that balance access with safety.

The current rules say a doctor must have an established patient-provider relationship, a documented medical history and ongoing care plan between a licensed clinician and a patient before prescribing certain drugs like Adderall or Xanax over video. This doesn’t always mean a physical exam—it can be a previous in-person visit, or a telehealth visit that happened under the old emergency rules before May 2023. If you’ve never met your provider in person, they can still prescribe for up to 30 days under limited exceptions, like if you live in a rural area with no nearby specialist or if you’re in a federally designated shortage zone. But after that, they need to see you face-to-face—or you won’t get another refill.

It’s not just about who can prescribe—it’s about DEA registration, the official credential that allows a licensed practitioner to handle controlled substances legally. Your doctor must have an active DEA number, and they must use it on every electronic prescription. If they don’t, the pharmacy can’t fill it. Some providers skip telemedicine entirely because of the paperwork, the compliance risk, or because they’re not DEA-registered for controlled substances. That’s why you might get told, "I can’t prescribe that remotely," even if you’ve seen the doctor before.

These rules affect real people every day. Someone with chronic pain might need a new opioid prescription after their regular doctor retires. A student with ADHD might need Adderall refills while away at college. A person managing anxiety might rely on Xanax during a crisis. Under the new DEA telemedicine rules, all of them face extra steps—sometimes delays, sometimes dead ends. But the system isn’t broken. It’s trying to stop drug diversion while still letting people get care when they need it.

What you’ll find below are real stories and practical guides from patients and providers who’ve navigated these rules. You’ll see how people manage their prescriptions under these limits, what alternatives exist when telehealth isn’t enough, and how to make sure your next remote visit actually leads to a filled prescription. No theory. No fluff. Just what works—and what doesn’t—when the DEA is watching.