Federal Government Permanently Extends Addiction Treatment Through Telehealth

As of Dec. 31, 2025, it’s easier for Americans with opioid use disorder (OUD) to get access to critical medications through telehealth visits, thanks to a pandemic-era rule that the federal government has made permanent. This change helps to ensure that more people can get the treatment they need, even if they cannot routinely see their health care providers in person.

Of an estimated 5 million American adults with OUD, only 1 in 5 receive medication—the most effective therapy available—to treat it. During the COVID-19 pandemic, the federal government temporarily allowed telehealth flexibilities for addiction treatment so that patients could practice social distancing rather than go to a provider’s office. Studies show that as a result of these flexibilities, more patients started taking buprenorphine (one of the three Food and Drug Administration-approved medicines to treat OUD) and that telehealth may even have reduced the risk of a patient discontinuing buprenorphine.

In January 2025, the U.S. Drug Enforcement Administration (DEA) and the Department of Health and Human Services jointly issued a final rule that allows patients to get buprenorphine prescriptions through audio-video or audio-only telehealth visits without first seeing their provider in person. The decision followed feedback given during a public comment period and listening sessions in 2023 and 2024, with the agencies concluding that “the benefits of increasing access to buprenorphine outweigh any added risk of diversion.” (Diversion occurs when people obtain such drugs indirectly or purchase them illegally to use or sell them to others.)

The final rule is more flexible for patients seeking treatment and should save lives. Under the rule, a health care provider can prescribe buprenorphine through telehealth for up to six months without an in-person visit—a significant extension from the 30-day prescription limit originally described in the DEA’s 2023 proposed rule. It also removes onerous recordkeeping requirements in the initial proposal that would have placed additional demands on providers conducting audio-only visits. That change reflects evidence indicating that both audio-video and audio-only buprenorphine prescribing are safe and effective.

After six months, patients can continue to get remote prescriptions if their providers complete a special registration with the DEA to prescribe controlled substances, or if other federal rules permit it. While it continues deliberating on the special registration process, the DEA made clear in the Fourth Temporary Extension of Telemedicine Flexibilities that providers can continue to prescribe remotely under the temporary extension until the end of 2026. 

This buprenorphine rule underscores the agencies’ commitment to making OUD treatment more accessible. Remote prescribing of the drug has helped more patients start and stay in treatment without increasing overdose deaths. And that success has been critical for a range of people, including veterans, people experiencing homelessness, people involved in the criminal legal system, people living in rural areas, and members of racial and ethnic minority groups. Audio-only visits have also played a key role in expanding treatment options by helping people without reliable internet access, among others.

The evidence shows that telehealth access to treatment helps more people with OUD get care. This decision by the federal government represents a critical step toward making a highly effective medication more available for people who need it.

Marcelo Fernández-Viña works on The Pew Charitable Trusts’ substance use prevention and treatment initiative.