Buprenorphine X-Waiver Update from the Substance Abuse and Mental Health Services Administration (SAMHSA)

With the signing of the Consolidated Appropriations Act of 2023, Congress has eliminated the "DATA-Waiver Program".

All DEA registrants should be aware of the following:

An X-Waiver registration is no longer required to treat patients with buprenorphine for opioid use disorder.
All prescriptions for buprenorphine only require a standard DEA registration number.
There are no limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine.

Information from SAMHSA on the intricacies of these changes can be found here.

November 4th, 2022

CDC Clinical Practice Guideline For Prescribing Opioids for Pain Update

The Center for Disease Control and Prevention has updated their Clinical Practice Guideline for Prescribing Opioids for Pain. These guidelines have been updated from the 2016 guidelines, with expanded recommendations that support clinicians and patients, and improve patient care and safety.

Specifically, the 2022 Clinical Practice Guideline is intended to help clinicians:

Improve communication with patients about the benefits and risks of pain treatments, including opioid therapy for pain
Improve the safety and effectiveness of pain treatment
Mitigate pain
Improve function and quality of life for patients with pain
Reduce the risks associated with opioid pain therapy (including opioid use disorder, overdose, and death)

September 7th, 2021

Statewide Overdose Safety (SOS) Workgroup Action Notice: Best Practices for Providers Who Inherit Patients on Opioids

On behalf of the Statewide Overdose Safety (SOS) Workgroup and partners, the California Department of Public Health (CDPH) is releasing an action notice to share widely as appropriate. This action notice for providers details best practices to consider and offers supportive resources to use when inheriting patients on opioid therapy due to facility closures and other causes. This action notice is signed by CDPH, Department of Health Care Services (DHCS), Department of Consumer Affairs (DCA), and the Medical Board of California (MBC). Read the full CDPH article here.

April 28th, 2021

Buprenorphine Prescribing Update from Health and Human Services

After the false start about the buprenorphine waiver changes in January 2021, we are delighted to share good news: Health and Human Services announced significant updates to the Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder.

Here is our summary of these updates, as we best understand it:

Who does this apply to: Physicians (MDs and DOs), physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives who have a state license and DEA number.
What changed:
- The new exemption allows eligible practitioners to apply for a waiver and get an X number to treat up to 30 patients with buprenorphine WITHOUT having to do the 8 or 24 hour certification training. All practitioners need to do is submit a form to request a new waiver by following the instructions on this page.
  - If any of the above practitioners wish to prescribe buprenorphine to more than 30 patients, they need to complete the corresponding 8 or 24 hour trainings per the old system and meet certain conditions.
- The exemption also allows practitioners to prescribe buprenorphine WITHOUT having to certify that they are able to provide counseling or other ancillary services, unless they intend to treat more than 30 patients.
When does it go into effect: Immediately, as of 4/28/2021.
The goal: Expand access to buprenorphine for opioid use disorder treatment!
What does it mean for me as a detailer: You can now encourage providers who only want to treat a small number of patients with buprenorphine to simply submit a waiver request to get started - a much lower lift than spending the weekend in online trainings!

Information from SAMHSA on the intricacies of these changes can be found here: https://www.samhsa.gov/medication-assisted-treatment/become-buprenorphine-waivered-practitioner.