The Authors’ Own Words: It will End in Tiers: A Strategy to Include “Dabblers” in the Buprenorphine Workforce After the X-Waiver

In this commentary, authors Brendan Saloner, PhD, Barbara Andraka Christou, PhD, JD, Adam J. Gordon , MD, MPH, and Bradley D. Stein, MD, PhD share their belief that the X-waiver will ultimately be repealed, but there is a need for a variety of strategies to create a new treatment system after the X-waiver. Building a new tier of treatment capacity will require educational outreach, systems strategies, and enhanced payments.

“A growing national movement is advocating for the elimination of the X-waiver, which could open the door to many more clinicians being able to prescribe buprenorphine. However, there is insufficient attention to how to incorporate these clinicians into the prescribing workforce. We argue that for the foreseeable future, clinicians with high-volume practices (“super-prescribers”) will lead the way, but there is a vital role to be played by clinicians who prescribe opportunistically or occasionally (“dabblers”). We outline a strategy focused on workforce development, systems of care, and payment that can help support this goal.”

You can read this commentary in SAj Volume 42, Issue 2 or online.