For the fourth time, remote prescribing of controlled substances will be allowed without permanent policy. The Trump administration appears poised to extend a temporary, Covid-era rule allowing health providers to prescribe certain controlled substances, like ADHD medications and treatments for opioid addiction, via telemedicine. Under the current rules, providers can initiate prescriptions for drugs like Ritalin or Adderall for ADHD, or buprenorphine for opioid use disorder, without first examining the patient in-person. A posting on a White House budget website, titled “Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications,” signals that the Trump administration has conceded the regulatory limbo will last at least one more year. It is unclear how the Trump administration might eventually move to finalize regulations for prescribing controlled substances via telemedicine. Among the most debated issues are whether the DEA should differentiate between Schedule II and Schedule III substances (like Ritalin and buprenorphine, respectively), and more generally, how stimulants used to treat ADHD should be regulated.