Updates in clinical guidance and regulations continue to shape how controlled substances are prescribed in 2026. Recent federal activity and clinical guidance brings attention to risk across controlled substance prescribing.
Federal focus on prescribing practices
In May 2026, the U.S. Department of Health and Human Services announced the MAHA Action Plan1, which includes a focus on reducing psychiatric prescribing, particularly in pediatric populations. The plan reflects increased attention to how medications are started, continued, and discontinued.
Similar themes exist across pain management and behavioral health, with a focus on ongoing evaluation, documentation, and awareness of risk.2
Key considerations, regardless of the medication involved
- Initiating medications with clear clinical rationale and expected benefit
- Reassessing therapy over time, including when continuation is appropriate
- Considering deprescribing when benefit is limited or unclear
- Reinforcing informed consent and shared decision-making
- Incorporating non-medication treatment options, including therapy, lifestyle changes, and family support.
- Monitoring for safety, including misuse and unintended effects
- Of note, reimbursement pathways may be available from CMS for deprescribing activities
The bottom line
Recent updates reinforce the importance of ongoing evaluation and documentation in controlled substance prescribing. Incorporating these practices into routine care can support clinical decision-making and risk management over time.
*Sources:
- U.S. Department of Health and Human Services. “HHS Launches MAHA Action Plan to Curb Psychiatric Overprescribing.” Published May 4, 2026. Accessed May 11, 2026. https://www.hhs.gov/press-room/hhs-launches-maha-action-plan-curb-psychiatric-overprescribing.html
- Goodman DW, Mago R, Citrome L, et al. The American Society of Clinical Psychopharmacology task force consensus statement on the deprescribing of stimulant medications in adults with ADHD. Eur Neuropsychopharmacol. 2026 May 20;111:112863. doi: 10.1016/j.euroneuro.2026.112863. Epub ahead of print. PMID: 42160906.