Since 2020, a lot of people have started and continued ADHD medication through telehealth. The rules behind that have changed several times, which has left many patients unsure where things stand. Here's a plain explanation, current as of November 2026.
Why stimulants have special rules
Most stimulant medications for ADHD, like Adderall, Vyvanse, Ritalin, and Concerta, are Schedule II controlled substances under federal law. That category comes with extra safeguards. Under a federal law called the Ryan Haight Act, prescribing controlled substances generally requires at least one in-person visit before a prescription can be issued through telehealth.
What's allowed right now
During the COVID-19 public health emergency, the DEA and HHS temporarily waived the in-person requirement. Those flexibilities have been extended several times. As of November 2026, they run through December 31, 2026. That means a qualified provider can currently evaluate you and prescribe stimulants through telehealth without an in-person visit, as long as the prescription is for a legitimate medical purpose.
Federal agencies have been working on permanent rules. What happens after December 31, 2026 depends on whether the flexibilities are extended again or replaced. We'll update this article as soon as there's news, and we'll let our patients know directly if anything changes for them.
What stays the same either way
- No refills. Federal law doesn't allow refills on Schedule II medications. Each prescription is issued new by your provider.
- Regular follow up. Stimulants need monitoring for how well they work, side effects, blood pressure, sleep, and appetite.
- Prescription monitoring. Washington has a Prescription Monitoring Program, and providers check it when prescribing controlled substances.
- Non-stimulant options exist. Some ADHD medications aren't controlled substances and have fewer restrictions. They're a good fit for some people.
How we handle it
Every patient starts with a full ADHD evaluation. If medication makes sense, we explain your options and follow up regularly through medication management visits. You can read more about how ADHD medication management works at our practice. If an in-person visit ever becomes required, we offer appointments at our Lakewood office and will help you plan for it.
If you or someone you love is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911. Mind & Metabolism is an outpatient practice and can't provide emergency care.
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Our board-certified psychiatric providers see teens and adults across Washington State by telehealth, with limited in-person visits in Lakewood. Most major insurance accepted.
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