The article, “Will the End of the X-Waiver Expand Access to Buprenorphine Treatment? Achieving the Full Potential of the 2023 Consolidated Appropriations Act,” has been published in SAj.
In this commentary, the authors state that the expansive Consolidated Appropriations Act of 2023 was the last major law passed by the 117th Congress, and for opioid use disorder (OUD), it may prove its most consequential. The Act repeals the requirement that clinicians who prescribe buprenorphine, a life-saving medication for OUD, obtain a special license (the “X-waiver”) from the Drug Enforcement Administration (DEA). The repeal of the waiver was long sought by advocates and had bipartisan support. The Drug Addiction Treatment Act of 2000 (DATA), which created the waiver requirement, was a Congressional compromise allowing office-based prescribing of opioids to treat OUD; but the law was constrained by decades of arcane federal controlled substances law.
In the AUTHORS’ OWN WORDS, they relate the importance of their work:
“The repeal of the X-waiver sets the stage for the expansion of buprenorphine treatment, but this potential can only be fully achieved by eliminating the bottlenecks that often cause patients to miss the chance to receive life-changing treatment. The difficult task that lies ahead is ensuring that the greater flexibility in the federal law is met by an educated workforce, empowered by state regulations, with the capacity to get patients into treatment when they need it the most.”