We did it! The removal of the X-waiver means even fewer barriers to prescribing buprenorphine.
The Mainstreaming Addiction Treatment Act took effect at the beginning of this year, resulting in federal law no longer requiring an X-waiver. Any prescriber with an active Drug Enforcement Agency (DEA) license can now treat patients with buprenorphine for medication for opioid use disorder (MOUD). Key details include:
- Buprenorphine remains a DEA Schedule III medication for all indications, including pain management and addiction treatment. It can be prescribed as MOUD by any clinician with an active DEA license that includes Schedule III medications.
- These changes take effect immediately. Clinicians are no longer able to apply for an X-waiver, and all previous X-waiver numbers have been removed by the DEA.
- The DEA posted a letter explaining these changes to all clinicians with a DEA license. We encourage you to share it with all prescribers in your hospital so that nobody misses this important news. The letter also states that training requirements will be added for all DEA applications and renewals starting in June 2023, but the details of this requirement have not been decided to date.
Take Action Now
Spread the word.
Make sure all of your prescribers know they do not need an X-waiver, and encourage them to start prescribing buprenorphine for patients with opioid use disorder.
Treat a patient. Save a life.
Have questions about when and how to start buprenorphine? CA Bridge is here to help. Check out our on-shift resources for answers, and follow CA Bridge for updated guidance, training, and related resources. Additional updates and guidance will be posted on the SAMHSA X-waiver webpage.
New X-Waiver Elimination FAQs
What do I do if my local pharmacy is unwilling to fill a prescription for buprenorphine for MOUD?
The DEA letter is a good resource to share with any local pharmacy unwilling to fill a prescription for buprenorphine for MOUD. If the pharmacy continues to refuse to fill buprenorphine prescriptions, you can file a formal complaint with the CA Board of Pharmacy.