New York, NY - In response to the U.S. Department of Health and Human Services’ release of new practice guidelines that will allow more DEA-registered practitioners to prescribe buprenorphine to up to 30 patients without obtaining an X waiver, Kellen Russoniello, Senior Staff Attorney for the Drug Policy Alliance, released the following statement:
“We are grateful to see the Administration finally embracing this common-sense approach to saving lives--which will immediately make 1.4 million more medical professionals eligible to prescribe buprenorphine to people with opioid use disorder. The X waiver requirement, which has deterred prescribing for two decades, is counterproductive and 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.
With overdose deaths at record levels and continuing to increase amid the COVID-19 pandemic, we must do everything in our power to provide people with opioid use disorder the support they need. These new guidelines--which remove some of the unnecessary burdens for more healthcare practitioners to be able to prescribe the life-saving medication buprenorphine--are a welcome first step.
However, more work remains. The new guidelines unfortunately still cap the number of patients a provider can serve without the waiver and require the provider to submit special notice to the federal government, which can delay their ability to start prescribing even after this guidance is formalized. Taken together, the change still perpetuates stigma, sending a message to practitioners that patients with opioid disorder are more difficult to treat.
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 once and for all, by passing the Mainstreaming Addiction Treatment (MAT) Act.”
These new guidelines will now allow all DEA-registered physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and certified nurse midwives to prescribe buprenorphine to up to 30 patients without the need to obtain additional permission from the DEA, known as an X waiver. Physicians will also no longer need to complete an 8-hour training and the other prescribers will no longer need to complete a 24-hour training in order to qualify. However, all practitioners will still need to submit an application known as a “Notice of Intent” to the Substance Abuse and Mental Health Services Administration before they begin writing prescriptions for their patients. When they take effect, these new guidelines could greatly increase access to what we know is a gold-standard for treating opioid use disorder.