The X-Waiver Has Been X’d

Buprenorphine is a highly effective treatment for opioid addiction. But access has been an issue.

Buprenorphine is one of three highly effective, FDA-approved medications to treat opioid use disorder. But in order to prescribe it, doctors have had to obtain a special waiver, called the DATA Waiver/X-Waiver, from the DEA. 

This waiver has long been considered an unnecessary hurdle that makes it harder for doctors to treat addiction in their communities, especially for patients from marginalized communities and in rural areas. 

Addiction doctors and healthcare professionals have been asking government agencies to “X the X-Waiver” for years now. And it looks like these advocacy efforts have finally paid off.

The bipartisan Mainstreaming Addiction Treatment (MAT) Act was included in a larger package of omnibus legislation that President Biden signed into law early this year. 

This specific bill calls for the elimination of the X-Waiver and for an educational campaign, led by the department of Health And Human Services (HHS), to ensure practitioners are made aware of the change. 

The results have already taken effect. The Department of Substance Abuse and Mental Health Services (SAMHSA) reports that the waiver has been eliminated, and states that prescribers “may now prescribe buprenorphine for Opioid Use Disorder in their practice if permitted by applicable state law and SAMHSA encourages them to do so.”

This is a big move that will save many lives. Dr. Rahul Gupta, Director of the White House Office of National Drug Control Policy (ONDCP), said in a statement, “This is a major step forward in our ongoing work to ensure universal access to medication for substance use disorder care by 2025 that the President supports and I look forward to seeing more people with opioid use disorder get the help they need.”

Without the X-Waiver requirement, more professionals can prescribe buprenorphine, saving lives and helping opioid use disorder patients find lasting recovery.

More medical professionals can now administer this lifesaving medication, providing immediate relief to patients whose lives are at risk. For a patient in early recovery, withdrawal management is one of the toughest parts. Buprenorphine eases this process, reducing withdrawal symptoms and tamping down cravings so that patients can focus on their lives and their health.

Rapid access to treatment is one of the most important Principles of Care for addiction. By allowing more everyday doctors to prescribe buprenorphine, more patients can quickly access the care they need — which can literally be a life or death matter.

Eliminating the X-Waiver also shatters stigma.

Having to obtain a special permit to prescribe buprenorphine, but not other medications, played into the false impression that this medication is especially dangerous, or that opioid use disorder patients are especially risky to treat. 

That’s not true. Buprenorphine is a safe and evidence-based treatment for opioid use disorder. Indeed, addiction itself is a highly treatable condition. Removing the X-Waiver ensures that these patients are treated just like those with any other illness, and it assures doctors that buprenorphine can be a regular tool in their treatment toolkit.

There’s still work to be done.

Due to the history of buprenorphine restrictions (as well as the historic lack of integration of addiction medicine into mainstream healthcare), there are still too few doctors who understand addiction and are prepared to treat it. Now though, there’s hope for change. 

In addition to the MAT Act, the MATE Act also passed — this legislation improves addiction educational requirements among healthcare professionals. By beefing up educational efforts and removing unnecessary restrictions, addiction treatment can finally be normalized in healthcare settings.

Do you or a loved one need treatment for an opioid use disorder?

Remember that treatment is effective, and it can begin right in your primary care doctor’s office. With the X-Waiver a thing of the past, healthcare professionals now have even more resources to get you on the path that’s right for you. Learn more about high quality addiction treatment and find resources near you.