CHA News Article

HHS Expands Access to Treatment for Opioid Use Disorder
For emergency department directors, behavioral health directors

The U.S. Department of Health and Human Services has eliminated the X-waiver for physicians, meaning that physicians can prescribe buprenorphine without taking an eight-hour course and without obtaining a waiver from the Substance Abuse and Mental Health Services Administration.  

The details are as follows:  

  • The exemption only applies to physicians who may only treat patients who are in the states in which they are authorized to practice medicine. 
  • Physicians using this exemption will be limited to treating no more than 30 patients with buprenorphine for opioid use disorder at any one time (note: the 30-patient cap does not apply to hospital-based physicians, such as emergency department physicians). 
  • The exemption applies only to the prescription of drugs or formulations covered under the X-waiver of the Controlled Substances Act, such as buprenorphine, and does not apply to the prescription, dispensation, or use of methadone for the treatment of opioid use disorder. 
  • Physicians using this exemption will be required to place an “X” on the prescription and clearly identify that it is being written for opioid use disorders (along with maintaining separate charts for patients being treated for opioid use disorder). 

An interagency working group will be established to monitor the implementation and results of these practice guidelines, as well as the impact on diversion. 

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