Ryan Haight Act
The Ryan Haight Act (2008) is the federal law requiring an in-person medical evaluation before controlled substances may be prescribed online — the statute whose telemedicine exceptions and temporary flexibilities govern what telehealth prescribing of controlled substances is allowed today.
- Requires an in-person exam before online controlled-substance prescribing
- Telemedicine flexibilities have suspended that rule since 2020
- Current extension runs through December 31, 2026
- The DEA special-registration rule was proposed in 2025, not yet final
What the Act requires — and where telehealth fits
Passed after the death of Ryan Haight, who obtained opioids from an online pharmacy without ever seeing a doctor, the Act amended the Controlled Substances Act to require at least one in-person evaluation before a practitioner may prescribe controlled substances via the internet. It also defined telemedicine exceptions and directed the DEA to create a special registration for legitimate telemedicine practice — a registration the agency then took more than a decade to propose.
Where the rules stand now
COVID-era flexibilities suspended the in-person requirement in 2020, and the DEA has extended them repeatedly rather than let them lapse — the fourth extension runs through December 31, 2026. Under the flexibilities, DEA-registered practitioners may prescribe Schedule II–V substances via telemedicine (audio-video for most initial prescribing) without a prior in-person exam, subject to state law. The long-promised special-registration framework was finally proposed in January 2025 and remains unfinalized.
For program design the takeaway is stability-with-a-deadline: controlled-substance telehealth is lawful today under temporary rules, and every program built on it should watch the special-registration rulemaking — the permanent regime will set registration, modality, and recordkeeping requirements that temporary flexibilities only sketch.
Compliance handled, so you can build
Lithos runs the clinicians, pharmacies, and 50-state rules behind your care program — one API.
Frequently asked questions
Can telehealth programs prescribe controlled substances right now?
Yes, under the extended DEA flexibilities — via appropriate telemedicine encounters and subject to state rules — through at least the end of 2026.
What is the special registration?
A registration category the Act envisioned for legitimate telemedicine prescribing without a prior in-person exam. The DEA proposed the framework in January 2025; programs are waiting on the final rule.
Does the Act affect non-controlled prescriptions?
No — it governs controlled substances. Non-controlled telehealth prescribing is governed by state practice and modality laws.