Removing The X-Waiver Is One Small Step Toward Increasing Treatment Of Opioid Use Disorder, But Great Leaps Are Needed

by Erin J. Stringfellow, Keith Humphreys, Mohammad S. Jalali April 22, 2021

Buprenorphine treatment is among the most effective options for people with opioid use disorder (OUD), but it remains underutilized. Increasing buprenorphine treatment receipt is one of the most reliable ways to reduce opioid overdose deaths. Currently, the treatment of OUD with buprenorphine in outpatient settings is restricted to clinicians receiving an “X-waiver” under the Drug Addiction Treatment Act of 2000. To receive this waiver, qualified clinicians must attend waiver training sessions for eight hours; other eligible practitioners, including nurse practitioners and physician assistants, must attend an additional 16 hours of training. Clinicians must then submit a Notice of Intent to the Substance Abuse Mental Health Services Administration before they can begin prescribing; in some states, non-medical doctors must also have a qualified supervising physician.

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