How to Prescribe Controlled Substances Under COVID-19 Waivers
By David Doolittle


If you treat patients with chronic pain, you can temporarily prescribe certain controlled substances during a telemedicine visit under state and federal waivers issued in response to the COVID-19 pandemic. 

On May 8, the TMB extended a waiver that allows telephone refills of valid prescriptions for treatment of chronic pain by a physician with an established chronic pain patient.

"This suspension is only in effect until June 6, 2020,” the agency said. 

“The extended waiver continues to allow for telephone refill(s) of a valid prescription for treatment of chronic pain by a physician with an established chronic pain patient," TMB said in a statement. "The physician(s) remains responsible for meeting the standard of care and all other laws and rules related to the practice of medicine. The standard of care must still be maintained related to the treatment of chronic pain patients."

Meanwhile, the U.S. Drug Enforcement Administration (DEA) will allow DEA-registered physicians to issue prescriptions for all schedule II-V controlled substances via telemedicine as long as all of the following conditions are met:

  • The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice;
  • The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system; 
  • The practitioner is acting in accordance with applicable federal and state laws; and
  • The Secretary of Health and Human Services’ designation of a public health emergency remains in effect.

Prescriptions can be issued using any of the methods of prescribing currently available, including electronically (for schedules II-V), or by calling in an emergency schedule II prescription to the pharmacy, or by calling in a schedule III-V prescription to the pharmacy.

As a reminder, the physician must still check the patient’s Prescription Monitoring Program (known as PMP Aware) history before dispensing or prescribing opioids, benzodiazepines, barbiturates, or carisoprodol.

Find more information about telemedicine, including updates related to COVID-19, on the TMA Telemedicine Resources webpage. 

For the latest news and information on the coronavirus pandemic in Texas, including links to official CDC, DSHS, and TMB documents, be sure to visit the TMA COVID-19 Resource Center regularly.

Last Updated On

May 19, 2020

David Doolittle


(512) 370-1385

Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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