Key points
- Alprazolam is a Schedule IV controlled substance, according to its label, and our medicine pages give the status of each benzodiazepine.
- A temporary federal rule covers Schedule II to V telemedicine prescribing through December 31, 2026, under set conditions.
- The rule permits prescribing, but it does not require anyone to prescribe or entitle anyone to a prescription.
- FDA says prescribers should weigh the risks of abuse, misuse and addiction for each patient.
- Pennsylvania and New York both run prescription monitoring programs for controlled substances.
The short answer
It can be legally possible, but the rules do not promise it to anyone. Whether a benzodiazepine is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help.
Be cautious with any website that promises a specific controlled medicine before anyone has reviewed your history. Federal rules say a prescription must be for a legitimate medical purpose, issued by a practitioner acting in the usual course of professional practice.
Why benzodiazepines have extra rules
The alprazolam (Xanax) label says it contains a Schedule IV controlled substance. Its patient guide explains this is because it can be abused or lead to dependence. Benzodiazepines as a class carry an FDA boxed warning about risks of abuse, misuse, addiction, physical dependence and withdrawal reactions, and about serious risks when taken with opioids.
FDA says that, when deciding whether benefits outweigh risks, health care professionals should consider the patient's condition and other medicines, and assess the risk of abuse, misuse and addiction. It also tells them to limit dosage and duration to the minimum needed and to monitor patients throughout therapy.
What the federal rule says
As of November 2026, a temporary federal rule (Federal Register, Fourth Temporary Extension) allows DEA-registered practitioners to prescribe Schedule II to V medicines by audio-video telemedicine without a prior in-person evaluation, under set conditions, through December 31, 2026. Rules may change after that date.
The set conditions listed in the rule include these points, stated here as general information and not legal advice.
- The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of professional practice.
- It is issued through a communication between practitioner and patient using an interactive telecommunications system.
- The practitioner is authorized under their DEA registration to prescribe that class of controlled substance, or is exempt from registration under federal law.
- The prescription is consistent with all other federal requirements for controlled substance prescriptions.
Prescriber judgment comes first
A rule that allows something is not the same as a clinician deciding it is right for you. The National Institute of Mental Health (NIMH) says taking benzodiazepines over long periods may lead to tolerance or dependence, so providers usually prescribe them for short periods and taper them slowly. It also describes other types of medicine used for anxiety.
A careful prescriber may ask about your diagnosis, what you have tried, other medicines and any opioid use, alcohol use and past trouble with medicines. They may suggest something else, or may want more information first. If you are told no, you can ask why, and what the other options are. You can read more about benzodiazepines for anxiety and non-benzodiazepine options.
If you already take a benzodiazepine
- Please do not stop suddenly or cut back on your own. The label warns that this can cause withdrawal reactions that can be life-threatening.
- Bring the name of the medicine and how long you have taken it to your visit.
- Tell any new prescriber who else has been prescribing it.
State prescription monitoring
Both states we serve keep records of controlled medicines. Pennsylvania's Department of Health says its Prescription Drug Monitoring Program collects information on all dispensed controlled substance prescriptions, to help health care providers prescribe them safely.
New York's Department of Health says most prescribers are required to consult its Prescription Monitoring Program Registry when writing prescriptions for Schedule II, III and IV controlled substances. In practice, this means a prescriber may be able to see what has been dispensed to you, so being open from the start is the simplest path.
How we can help
A licensed psychiatrist on our team treats anxiety online by secure video for people physically located in Pennsylvania or New York during each visit. This page is not an offer of any medicine. Whether it is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help: contact us about medication care, or read about online anxiety treatment.
If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services.
Common questions
Is Xanax a controlled substance?
Yes. The Xanax label says it contains alprazolam, a Schedule IV controlled substance, and its patient guide says it is federally controlled because it can be abused or lead to dependence. Each medicine's own page gives its status. Keep these medicines in a safe place, and never share them with anyone.
What happens to the rule after December 31, 2026?
No one can say for certain yet. The current Federal Register rule runs through December 31, 2026, and rules may change after that date. If this matters for your care, ask your prescriber how they plan for it. Please do not change how you take a medicine because of something you read about rules.
Does your psychiatrist prescribe benzodiazepines online?
We cannot promise any particular medicine. Whether it is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help. He sees people by secure video in Pennsylvania and New York. Any medicine decision comes after a full conversation about your history, and a visit may not end in a prescription.
Can a prescriber see my other prescriptions?
Often, for controlled medicines. Pennsylvania's Prescription Drug Monitoring Program collects information on all dispensed controlled substance prescriptions and shares data with other states. New York's registry gives practitioners access to dispensed controlled substance histories for their patients. Telling your prescriber directly remains the clearest route, so your care stays safe.
Sources
- Federal Register: Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications
- DailyMed (FDA label): Xanax (alprazolam)
- U.S. Food and Drug Administration: FDA Requiring Boxed Warning Updated to Improve Safe Use of Benzodiazepine Drug Class
- National Institute of Mental Health: Mental Health Medications
- Pennsylvania Department of Health: Prescription Drug Monitoring Program
- New York State Department of Health: PMP/I-STOP Prescription Monitoring Program
Published by Locascio Wellness. Published November 5, 2026. Clinically reviewed by Kenneth M. Levy, DO, Psychiatrist (Pennsylvania license OS007464L). This page is general information, not medical advice or a diagnosis.