Access More Information

For 2026, the Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications permits all controlled substances to be prescribed via telemedicine without an in-person medical evaluation until December 31, 2026. Most telemedicine controlled substance prescriptions, including those for buprenorphine, are expected to be written pursuant to this fourth extension or 21 U.S.C 829(e).  

The Expansion of Buprenorphine Treatment via Telemedicine Encounter went into effect on December 31, 2025. In 2026, unless a practitioner explicitly states a prescription was issued under this specific rule, pharmacists can assume buprenorphine prescriptions fall under the fourth extension, delaying the requirements in the buprenorphine-specific rule. Notably, the buprenorphine-specific rule requires pharmacists filling buprenorphine telemedicine prescriptions to verify that the identity of the individual picking up the prescription matches the name of the patient or a member of the patient’s household. It also imposes a 6-month limit on prescribing buprenorphine via telemedicine without an in-person visit. These requirements are not in effect for prescriptions written under the fourth extension.

See our Telemedicine page for more details.

Effective January 22, 2026, the Kentucky Board of Medical Licensure has amended 201 KAR 9:270, which establishes professional standards for the prescribing of buprenorphine by physicians and PAs. The regulation now permits buprenorphine to be dosed up to twice daily. Additionally, buprenorphine may be prescribed concurrently with other controlled substances for 3 months before a formal consultation with an addiction medicine expert must be obtained and documented.  Please refer to the full text and markup of 201 KAR 9:270 for more details and additional revisions.        

On December 26, 2024, FDA issued a Federal Register notice to encourage changes to the labeling for buprenorphine-containing transmucosal products for the treatment of opioid use disorder and issued a letter to health care professionals regarding the recommendations. The current buprenorphine label does not include a maximum daily dose. Updated labeling language was approved on buprenorphine products in 2025 and the labels no longer refer to a "target dose."  

• Kentucky Board of Medical Licensure: 201 KAR 9:270
• Kentucky Board of Nursing: 201 KAR 20:065

• Kentucky Board of Medical Licensure
  • (502) 429-7150
  • Grievance information
• Kentucky Board of Nursing
  • 502-429-3300
  • Complaint information
• Drug Enforcement and Professional Practices Branch (DEPPB): (502) 564-7985

• National Opioids Settlements
• Gulf Med Pharmacy Decision and Order
• U.S. Pharmacist article explaining Ruan Supreme Court decision 

• NABP and NCPA: The Pharmacy Access to Resources and Medication for Opioid Use Disorder  (PhARM-OUD) Guideline
• National Opioids Settlements
• DEA Guidance Document on Suspicious Order Monitoring  (January 20, 2023)
• DEA and HHS: Dear Registrant Letter about MOUD
• Press release about legislative effort to exempt buprenorphine from Suspicious Orders Report System 

• Certification Matters search tool from American Board of Medical Specialties 
• American Board of Medical Specialties Certificates  

• Find Help Now Kentucky
• Ky Cabinet for Health and Family Services, Local Health Departments
• SMART Recovery

• Partnership to End Addiction, Words Matter: The Language of Addiction 
• National Institute on Drug Abuse, Words Matter - Terms to Use and Avoid When Talking About Addiction 

• SAMHSA, Practical Tools for Prescribing  and Promoting Buprenorphine  in Primary Care Settings
• AAFP, Addressing Social Determinants  of Health in Primary Care

• NPTA, How to Improve Your Customer Service Skills in the Pharmacy

• American Society of Addiction Medicine: The ASAM National Practice Guideline
• NABP and NCPA: The Pharmacy Access to Resources and Medication for Opioid Use Disorder Guideline
• Clinical Opioid Withdrawal Scale (COWS)

• Kentucky Board of Medical Licensure: 201 KAR 9:270
• Kentucky Board of Nursing: 201 KAR 20:065
• DEA and HHS: Dear Registrant Letter about MOUD
• Telemedicine Prescribing Updates from P2P-BRIDGE

• National Academies of Sciences, Engineering, and Medicine: Medications for Opioid Use Disorder Save Lives
• Kentucky Office of Drug Control Policy: Overdose Fatality Report for 2023
• SAMHSA's December 2023 Advisory, Low Barrier Models of Care for Substance Use Disorders, is no longer available online. To learn more about low-barrier care, see AHRQ's brief The Role of Low-Threshold Treatment for Patients with OUD in Primary Care  

• REMS: Buprenorphine-containing Transmucosal products for Opioid Dependence
• REMS: Brixadi
• REMS: Sublocade