Effective January 2023, all health care providers with a DEA registration that includes Schedule III authority can prescribe buprenorphine to treat patients with Opioid Use Disorder. An X-Waiver is no longer required to prescribe buprenorphine. This change follows the passage of the Mainstreaming Addiction Treatment (MAT) Act in December 2022.
In addition, per the Medication Access and Training Expansion (MATE) Act, starting June 27, 2023 all health care practitioners who apply newly for or seek to renew their DEA registration will be required to complete 8 hours of relevant accredited education related to the prevention, recognition, and care of people with substance use disorders. The 8 hours can be satisfied through a combination of activities and do not have to be included in one session.
For more information, including links to SHM activities that count towards the attestation of training completion, please visit DEA Licensure Requirement.
How did we get here?
In 2000, Congress passed the Drug Addiction Treatment Act (DATA 2000), which created the X-Waiver program to enable waivered clinicians to prescribe buprenorphine outside of methadone clinics and similar settings. Because the X-Waiver required additional steps and training, Medication-Assisted Treatment (MAT) with buprenorphine has been underutilized. Since 2018, SHM has advocated for the elimination of the X-Waiver so that hospitalists can more effectively treat patients with opioid use disorder and be able to prescribe this lifesaving medication at discharge.
In December 2022, the omnibus funding package signed by President Joe Biden effectively cancelled the X-Waiver requirements for physicians and NPs/PAs to prescribe buprenorphine.
Below are statements from the DEA and SAMHSA:
Webinar: How to be a Hospitalist Opioid Use Disorder Champion
2020 was a record year for drug overdose deaths. The hospitalist role in providing effective care for patients with opioid use disorder (OUD) has never been more important. Recent policy changes to the X-Waiver for treating OUD have made it easier for more hospitalists to engage in this work at a critical teachable moment.
In this webinar, two physicians and one physician assistant discussed their experience in becoming OUD treatment champions. Each panelist practices in different regions of the country and shared strategies for obtaining institutional support, identifying community partners for post-discharge treatment linkage, and reducing stigma experienced by patients with OUD. Physician panelists discussed their path to Addiction Medicine Board certification, and opportunities for board certification outside of an Addiction Medicine fellowship program which are available through 2025. Please note that this webinar was recorded in 2021, prior to the X-Waiver elimination in 2023.
Read more about Buprenorphine Practice Guidelines