Oakland, CA, Thursday,  April 29, 2021

Important Takeaways: HHS Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder

Here’s the most important takeaway of the “HHS Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder”: All prescribers with a valid state license and DEA can register for an X wavier without mandatory training. It’s now a simple process. Get your X waiver TODAY!  

3 Easy Actions to Stop the Overdose Crisis:

Sign up for your X waiver. 

 For these new guidelines to work, everyone must sign up. Go to http://buprenorphine.samhsa.gov/forms/select-practitioner-type.php to register for your X waiver today.*

Spread the word.

Encourage all prescribers to sign up now. Your health systems, clinics, and physician groups should all let prescribers know about this critical update and the steps they should take. 

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. 

* Here are step-by-step instructions for guidance on how to complete the X waiver registration online form

New HHS Practice Guidelines FAQs

Prescribers no longer need to complete the MAT training for the 30 patient limit.

How do I apply for an X waiver?

Go to the SAMHSA website to apply for the X waiver through the notification of intent (NOI). You will need your state license and DEA registration. When the system asks for Certification Qualification Criteria check “Other” and write in “Practice Guidelines.” (Please note, there have been reports of an error message regarding a form showing completed CME, which will hopefully be fixed. (SAMHSA buprenorphine info center can confirm submission via infobuprenorphine@samhsa.hhs.gov).  

How long will it take to get my X waiver once I apply? 

SAMHSA will review applications within 45 days of receipt. Once the application is complete and the application is approved, SAMHSA will email an approval letter. The DEA will follow up with an updated DEA license showing X waiver. The whole process can take two months – a good reason to start the process now.

How do I write a prescription using my X waiver?

Once you have received your X waiver, you write a prescription for buprenorphine for opioid use disorder by indicating your X waiver license number on the prescription. The pharmacist will have no indication if the X waiver license was obtained after 8 hours of training or not. You can e-prescribe buprenorphine for opioid use disorder by indicating your X waiver license number in the “notes to pharmacy” section or NADEAN: x-license number section in the EHR.

How does the 30 patient limit work? 

The removal of the training requirement allows you to apply for an X waiver for up to 30 patients. The limit of 30 patients applies only to active patients and is not an annual limit. A patient counts for this limit for the duration of the prescription. For example, an ED physician can write 30 one-week prescriptions weekly and up to 120 one-week prescriptions in a month and still be within the 30 patient limit. 

Additional Resources

Now prescribing bup is that easy: Sign up. Spread the word. Save a life.  We can solve the overdose crisis together. 

California Bridge is a program of the Public Health Institute. Our goal is that people with substance use disorder receive 24/7 high-quality care in every California health system.  Funding for Bridge is provided through the Substance Abuse and Mental Health Services Administration (SAMHSA) State Targeted Response to the Opioid Crisis Grant to the California Department of Health Care Services (DHCS).