New York, NY - In response to the U.S. Department of Health and Human Services’ release of new practice guidelines that will allow DEA-registered physicians to prescribe buprenorphine without obtaining an X waiver, Kellen Russoniello, Senior Staff Attorney for the Drug Policy Alliance, released the following statement:
“With overdose deaths at record levels and continuing to increase amid the COVID-19 pandemic, we welcome Health and Human Services’ new guidelines, which remove unnecessary burdens for doctors to be able to prescribe this life-saving medication to people with opioid use disorder.”
These new guidelines allow all DEA-registered physicians to prescribe buprenorphine to up to 30 patients without the need to obtain additional permission from the DEA, known as an X waiver. When they take effect, these new guidelines could greatly increase access to what we know is a gold-standard for treating opioid use disorder.
While a major step forward, much more needs to be done to ensure access for people in need. The guidelines do not apply to non-physician health professionals, such as nurse practitioners and physician assistants, who must still obtain an X waiver in order to prescribe the medication. Further, the new guidelines still only allow physicians to prescribe to a maximum of 30 patients. Barriers to access, especially in rural areas and in communities of color, will remain prevalent unless the federal government takes further action towards broader systemic change.
The X waiver requirement is clear evidence of the stigma that exists against people with opioid use disorder. No other health condition is subject to patient limits, and no other medication requires a special waiver to prescribe. Federal agencies should take immediate action to increase access to buprenorphine and other highly effective treatments - such as methadone, and Congress should heed the calls of practitioners, advocates, and public health experts across the country to eliminate the X waiver altogether.”