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Ryan Haight Act

On May 10, 2023, the Drug Enforcement Agency released regulations that extended certain waivers in the Ryan Haight Act. If you receive controlled substances through telehealth, then these changes may be relevant to you. But what is the Ryan Haight Act, and what do these recent changes entail? We’ll go over everything you need to know in today’s blog.

In the meantime, if you’re seeking primary care through telehealth, you can click below to schedule a same-day appointment with a provider at Circle Medical.

A Brief Introduction

The COVID-19 pandemic changed the world in many ways, and the medical industry especially had to make radical adjustments to serve the population while minimizing the spread of the virus. The adjustments made to the Ryan Haight Act were just a few of the major changes people saw in healthcare during the pandemic.

However, on May 11, 2023, the federal declaration of COVID-19 as a public health emergency ended. This means that some of the temporary measures put in place during the pandemic will gradually be rolled back to bring things back to normal. One of these rollbacks will be how controlled medications through telemedicine are handled. The adjustments to the Ryan Haight Act put into place in 2020 in response to the pandemic temporarily changed some of the restrictions around prescribing controlled substances, but that is being gradually rolled back as well.

Understanding Telemedicine and Controlled Medications

Telemedicine has been around for a while now, and it has only grown in popularity in recent years as its capabilities have evolved. The pandemic made telehealth more necessary than ever before, as it was much safer for many people to receive care from home rather than go to an in-person clinic and potentially expose themselves to COVID-19.

While registered telehealth clinics can prescribe medication in the states where they have DEA registration and meet other requirements, the option to prescribe controlled medications had caveats for non-telehealth practitioners before the pandemic. Namely, patients would need to have at least one in-person medical evaluation before they could receive prescription medication. With that in mind, let’s talk about the Ryan Haight Act.

What Is the Ryan Haight Act?

The Ryan Haight Act was first introduced in 2008 to regulate the distribution of controlled substances over the Internet. The act was introduced to protect consumers, ensuring that illegal online pharmacies couldn’t easily dispense controlled medications to people who didn’t need them or didn’t have a prescription. 

A key provision of the Ryan Haight Act was that practitioners would need to conduct at least one in-person medical evaluation of their patients before providing prescriptions through telemedicine. The exception to this provision is the “telemedicine exception,” which allows telehealth providers to prescribe medications if they meet certain requirements. Amongst these requirements are the provider must be registered to prescribe medication in their state or the state they offer services, and they must be able to conduct a real-time evaluation through telehealth technology (phone or video). There are additional requirements, but you get the general picture.

In 2020, this model changed due to the pandemic and the need for people who weren’t using telehealth before to be able to receive care and prescriptions from their primary care provider without going to their in-person clinic. Now, these flexibilities have been extended in response to the end of the COVID-19 public health emergency declaration. Let’s take a look at the changes you need to know about.

DEA's Response To the Growing Need for Telemedicine

The DEA opted to extend two major controlled substance flexibilities it put in place during the pandemic. These flexibilities include:

  • Patients can be prescribed schedules II-V controlled substances without a prior in-person evaluation. You can receive care in your normal scope of practice even if you only have access to audio-only communication with your practitioner.
  • DEA registration in one state allows the prescription of controlled substances in any state. This makes it easier for people who may have moved during the pandemic to continue to receive care from their previous primary care provider in a different state.

These flexibilities have been extended to November 11, 2023, which is six months after the end of the public health emergency declaration. These extensions are intended to ensure that patients don’t see lapses in the care they need as these emergency flexibilities are rolled back.

Another important provision to note is the fact that there is an off-ramp period for patients who have established a telehealth relationship between the dates of March 2020 and November 11, 2023. If you receive telehealth treatment or prescriptions anytime between these dates, these flexibilities will continue to apply to you for an additional year up to November 11, 2024.

While these emergency measures were put in place to help people get care during COVID, these extensions point to the DEA’s understanding of the importance of telehealth and access to care for people whose best avenue might be telehealth. As telehealth continues to evolve and become more advanced in its capabilities, it will be interesting to see how the Ryan Haight Act and the DEA adjust to ensure people are getting the best quality care possible.

Pros and Cons

If you’re considering telehealth as an option for care, now is a great time to start looking into options. Many people switched to telehealth out of necessity during the pandemic, but there are plenty who will continue to use it due to its convenience and advantages that you can’t get from in-person care. Still, it’s always important to weigh your options and choose the best healthcare option for your individual needs. With that being said, here are some considerations to keep in mind if you’re thinking of switching to a telehealth provider:


Convenience — One of the key benefits of telehealth is how convenient it is for patients. When you go to an in-person clinic, you don’t just walk in, talk with your doctor and walk out. You have to commute to your clinic, possibly miss school or work, sit in a waiting room and drive back home. This can easily take hours out of your day. With telehealth, you can make an appointment that works with your schedule, get in touch from the comfort of your own home and get connected to your provider right away.

Comfort — Even the nicest doctor’s office isn’t going to be as comfortable as your couch. When you receive care from home, you can be in the most comfortable environment possible. For some people, this makes it easier to open up with their doctor and talk about the concerns they have.

Access — Not everyone has easy access to quality in-person care. Those in rural communities and remote areas can get comprehensive primary care without having to drive for miles. This also increases access for people who may have disabilities or health complications that make it difficult for them to get to the doctor’s office.

Limited exposure — COVID-19 made this a concern for many people, but reducing your exposure to waiting rooms and environments where people may be sick is a plus for most people.


Limitations — While telehealth can address many primary care concerns, certain conditions and diagnoses require in-person visits. X-rays, blood work and other in-person tests can’t be done over the phone. The good news is telehealth providers can always order lab work and send you to a nearby lab to conduct the tests you need.

Technology — You do need access to a phone and an Internet connection or cell service to utilize telehealth. While cell phones are more ubiquitous than ever, this can still be a barrier to entry for some people.

In the end, you’re in charge of your care, so you should always go with the option that makes you the most comfortable.

What To Expect for the Future

With the extensions to the emergency Ryan Haight flexibilities, you can continue to receive the care you’ve been receiving up to at least November 11, 2023, and even longer if you meet the requirements for the off-ramp period. As for the future, it’s evident that telehealth is necessary and even preferable for many people. We’ll just have to wait and see how the regulations around telehealth continue to change as more people choose online providers for their primary care needs.

Book an appointment with a Circle Medical telehealth provider today!

If you’re looking for a quality telehealth primary care provider, Circle Medical is your answer! Circle Medical is a fully licensed medical practice that offers a blend of in-person and virtual care. We cover primary and preventive care, as well as treat a variety of conditions.

We make things easy with our convenient app, where you can schedule appointments, access treatment plans and prescriptions and get in touch with your provider. Ready to get started with telehealth? Make a same-day appointment at Circle Medical today!

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