ACCMA News

X-Waiver Eliminated, Removing Barriers to Substance Use Treatment

March 8, 2023 Opioids/Substance Use buprenorphine, MAT, medication assisted treatment, opioid use disorder treatment, OUD, x-waiver

X-Waiver No Longer Required for Prescribing Buprenorphine:
What You Need to Know

In a national effort to facilitate the treatment of Opioid Use Disorder (OUD), practitioners no longer need to apply for an x-waiver.  The Omnibus bill passed in December 2022 removed this requirement.  All practitioners who have a current DEA registration that includes Schedule III authority, may now prescribe buprenorphine for OUD.

Additionally, there are no longer any patient caps for treating OUD with buprenorphine.  Previous standards that had limited this type of intervention are now removed.  Practitioners may treat any number of OUD patients with buprenorphine.

While these changes are endorsed by the DEA, SAMSHA, and multitudes of health care partners, it is also recognized that the treatment of OUD is best accomplished with knowledge about addiction and recovery.  To this end, the Omnibus bill includes another provision that bolsters training requirements for clinicians prescribing all controlled substances, called the Medication Access and Training Expansion (MATE). 

This law requires all providers who apply for a DEA license to prescribe controlled substances undergo a one-time, non-repetitive, 8-hour training on managing patients with opioid and other substance use disorders. Specifically, the law requires that if a prescriber is licensed to dispense controlled substances in schedule II, III, IV, or V, that provider must undergo the eight-hour training course, effective the first applicable registration/renewal for the practitioner.  The training will be presented by a multitude of providers.  The Attorney General will be notifying qualified practitioners/all DEA registrants of this new requirement by March 22, 2023. The American Medical Association sent a letter to the DEA and SAMHSA detailing recommendations on the implementation of the MATE Act requirements. In the letter, the AMA highlighted the barriers that the training and requirements are likely to create.

What do I do if my local pharmacy is unwilling to fill a prescription for buprenorphine for OUD? Share the letter from the DEA (linked below) with any local pharmacy unwilling to fill a prescription for buprenorphine for OUD. If the pharmacy continues to refuse to fill buprenorphine prescriptions, you can file a formal complaint with the CA Board of Pharmacy.

The ACCMA will continue to follow these ongoing changes and provide updates as more information becomes available. Resources for more information: