New DEA Rules Are on the Horizon for Telehealth Ketamine Clinics

Good morning and welcome back to The Drop In. We’re kicking things off with a look at how the DEA’s latest move is shaping the future of telehealth medicine businesses.

The DEA has extended Covid-era telehealth prescribing rules for controlled substances, buying time (but not certainty) for at-home ketamine providers operating digitally. What the delay signals, and what it doesn’t, is the focus of today’s news story. You can find that immediately below!

If you keep scrolling, you’ll find a piece on the best places to trip, LSD for PMS and PMDD, and psychedelics for long Covid.

Enjoy the ride 🌀,

Mary Carreón
Editor-in-Chief

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DEA Is Gearing Up to Reshape Telehealth Prescribing Rules

The eventual rule changes are expected to affect the prescribing of all controlled substances, including at-home ketamine services.

The Drug Enforcement Administration just extended Covid-era telemedicine flexibilities for prescribing controlled substances through December 31, 2026, buying the agency more time to finalize permanent rules that will shape the future of virtual care. For ketamine telehealth providers — many of which have built national, mail-order businesses — this move offers temporary relief, but long-term certainty remains in question.

The extension preserves a drug prescribing practice that was prohibited prior to lockdowns: allowing clinicians to prescribe certain controlled medications without first conducting an in-person visit. Without it, federal rules would have reverted to pre-Covid standards, effectively shutting down large segments of telehealth prescribing overnight.

The delay doesn’t mean that the DEA is trying to eliminate the telehealth law amended during Covid. Rather, it reflects the DEA’s effort to close regulatory gaps and tighten control over telemedicine frameworks.

“Covid didn’t create, but it exposed, a shortcoming in our prescribing rules,” said Matt Brockmeier, a drug policy attorney at Antithesis Law who advises psychedelic and cannabis-adjacent companies. “They didn’t reflect modern medical practice.”

The pandemic proved that in some cases, an entirely remote clinician-patient relationship can be appropriate, particularly when supported by lab work or monitoring that does not require an in-person physician visit. “Some type of modern telehealth prescribing regime makes sense,” Brockmeier said, especially given cost and barriers to access. Since the pandemic, however, the proliferation of at-home ketamine therapy (which involves a clinic sending ketamine to your home via mail) has raised concerns among some mental health professionals.

“I joke a lot that direct-to-consumer ketamine companies are like glorified drug dealers,” Lauren Taus, a long-time ketamine-assisted psychotherapist, told DoubleBlind in a story published back in 2023. “This is pioneering territory, and there’s going to be collateral damage,” Taus continued. “There’s a shadow side to ketamine’s benefits—a lot of addiction.”

Still, the DEA’s proposed solution — which includes a new registration system for telehealth prescribers of controlled substances — has raised concerns across the industry. More regulation, particularly this kind, doesn’t necessarily favor smaller ketamine companies.

At the same time, Brockmeier emphasized that ketamine occupies a distinct regulatory space. Unlike the classic psychedelics, it is a synthetic pharmaceutical with known safety and addiction risks. “Instead of outright prohibiting telehealth ketamine, this feels like an acknowledgment that this [telehealth prescribing system] is going to happen, and here’s a system for doing it. It is good policy to have an already established system in place when other psychedelics, like psilocybin, MDMA, 5-MeO-DMT, or ibogaine are inevitably approved at the federal level.”

The DEA has said the temporary rule will operate alongside newer, more restrictive telehealth regulations already finalized for certain drugs, including buprenorphine, a drug used for opioid use disorder. That dual-track approach has left providers uncertain about what standards will ultimately apply to ketamine.

If the temporary flexibilities lapse at the end of 2026 without a replacement rule, the consequences could be immediate. Patients who have only ever received ketamine through telehealth could suddenly lose access, while providers would be forced to rapidly restructure or shut down entirely.

For now, the extension offers an extended window of time for ketamine telehealth companies to continue business as usual, while the DEA writes its new rules for at-home pharmaceutical drug services. The real question for ketamine telehealth is not whether regulation is coming—but how disruptive it will be when it does.

Are Psychedelic Practitioners Incorporating Ethics Into Their Practices?

As access to psychedelics for medical, spiritual, and recreational use expands across the U.S. and abroad, questions of psychedelic ethics — both above and underground —have become increasingly difficult to ignore. What responsibility looks like in a rapidly evolving landscape remains a source of both intrigue and tension.

And while there is no shortage of cautionary tales involving unethical use, administration, and oversight in both clinical and underground settings, this Friday’s featured story turns the focus elsewhere: on psychedelic community leaders and organizations working to embed rigorous ethical standards into the foundation of what is becoming a new, semi-underground psychedelic ecosystem.

Upgrade your subscription here to get the full story written by journalist Jack Gorsline.

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• DoubleBlind just published its first book—and DoubleBlind+ members get a free copy of The DoubleBlind Guide to Psychedelics, a beautifully designed, safety-forward handbook covering substances, dosage, contraindications, and what to expect. Learn more here.

• Turn insight into practice with “Stabilize” from our friends over at BioPsych Renewal and Vine of the Soul. Book a free Discovery Call and get 15% off with the code: DOUBLEBLIND15

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Together With Vine of the Soul – BioPsych Renewal Program (BPR)

No amount of Ayahuasca will fix your life. You fix your life.

The medicine can show you the truth. Stabilize is the part that makes it stick: nervous system capacity, sleep, rhythm, and follow-through. Download “Why Integration Fails” including a 7-day Stabilize stack. 

Turn insight into Practice with “Stabilize”.

Book a free Discovery Call and get 15% off with the code: DOUBLEBLIND15 (not combinable with other discounts).