In a major advance for patients with opioid use disorder (OUD) and efforts to end the epidemic of drug overdose and death, the Consolidated Appropriations Act of 2023 eliminated the requirement for physicians to obtain a waiver from the Drug Enforcement Administration (DEA) to prescribe buprenorphine for OUD treatment. AMA policy has long viewed the x-waiver requirements as a significant barrier to expanding access to this highly effective treatment for OUD. The requirements that have been removed include making records of OUD treatment accessible to the DEA for audits and caps on the number of patients for whom buprenorphine could be prescribed.
Soon after the new law was passed, DEA Administrator Anne Milgram sent a letter to all DEA-registered physicians informing them that the elimination of the waiver requirements takes immediate effect. Administrator Milgram emphasized that the DEA’s goal is for OUD medication to be readily and safely available to anyone in the country who needs it. The letter states:
- A DATA-Waiver registration is no longer required to treat patients with buprenorphine for opioid use disorder.
- Going forward, all prescriptions for buprenorphine only require a standard DEA registration number. The previously used DATA-Waiver registration numbers are no longer needed for any prescription.
- There are no longer any limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine.
- The Act does not impact existing state laws or regulations that may be applicable.
While the waiver requirements were viewed as a major barrier to reducing the gap between the number of patients who need OUD treatment and the number who obtain it, they were not the only gap. The AMA is continuing to focus on removing prior authorization barriers to treatment, enforcement of mental health and substance use disorder parity laws, as well as reducing the stigma that often accompanies both seeking and providing OUD treatment. More information on the physician community’s efforts to end the drug overdose epidemic are available.