On December 29, 2022, President Biden signed the fiscal year 2023 omnibus, passing the Mainstreaming Addiction Treatment (MAT) and Medication Access and Training Expansion (MATE) Acts. These bills were passed to expand access to buprenorphine for the treatment of opioid use disorder, and normalize and enhance substance use care across healthcare settings.
MACS is monitoring guidance from state and federal agencies closely and will update this page when more information becomes available. The resources on this page offer information about the new legislation and the implications for healthcare providers and programs.
With this provision, and effective immediately, SAMHSA will no longer be accepting NOIs (waiver applications). All practitioners who have a current DEA registration that includes Schedule III authority, may now prescribe buprenorphine for Opioid Use Disorder in their practice if permitted by applicable state law and SAMHSA encourages them to do so. - More from SAMHSA on Removal of DATA Waiver (X-Waiver) Requirement
>>> Get started providing access to lifesaving care: Expanding Access to Buprenorphine
Effective June 27, 2023 new or renewing DEA registrants will be required to have 8 hours of training on opioid or other substance use disorders, as well as the safe pharmacological management of dental pain, through an accredited source. The DATA-2000 waiver training to prescribe buprenorphine counts towards this requirement. Training hours do not have to be completed in one session and can be satisfied through cumulative sessions. - More from SAMHSA on Recommendations for Curricular Elements in Substance Use Disorders Training
When does the removal of the x-waiver go into effect?
As of December 29, 2022.
Are there still limits on the number of patients I can prescribe buprenorphine for opioid use disorder?
No, there are no longer any limits on the number of patients a prescriber may treat for OUD with buprenorphine.
Do I still need to keep a list of all patients treated with buprenorphine and all prescriptions written?
No, separate tracking is no longer required for prescribing buprenorphine.
What does the removal of the x-waiver mean for pharmacies?
It means pharmacy staff can fill buprenorphine prescriptions using the prescribing authority's DEA number. The prescriber does not need the DATA 2000 waiver for pharmacists to dispense buprenorphine. The caveat is that the depending on the pharmacy, the dispensing software may still require the x-waiver information in order proceed.
Who is responsible for satisfying this new training requirement?
All DEA-registered practitioners, with the exception of practitioners that are solely veterinarians.
How will practitioners be asked to report satisfying this new training requirement?
Beginning on June 27, 2023, practitioners will be required to check a box on their online DEA registration form—regardless of whether a registrant is completing their initial registration application or renewing their registration—affirming that they have completed
the new training requirement.
What is the deadline for satisfying this new training requirement?
The deadline for satisfying this new training requirement is the date of a prescriber’s next scheduled DEA registration submission—regardless of whether it is an initial registration or a renewal registration—on or after June 27, 2023. This one-time training requirement affirmation will not be a part of future registration renewals.
How can practitioners satisfy this new training requirement?
By engaging in a total of eight hours of training on treatment and management of patients with opioid or other substance use disorders via accredited continuing education sources.
How do I know if I already satisfied the training requirement?
The following groups of practitioners are deemed to have satisfied this training:
Group 1: All practitioners that are board certified in addiction medicine or addiction psychiatry from the American Board of Medical Specialties, the American Board of Addiction Medicine, or the American Osteopathic Association.
Group 2: All practitioners that graduated in good standing from a medical (allopathic or osteopathic), dental, physical assistant, or advanced practice nursing school within five years of June 27, 2023, and successfully completed a comprehensive curriculum that included at least eight hours of training on:
What accredited groups may provide trainings that meet this new requirement?
The training needs to be provided by or approved by one of the following organizations:
For additional information read the DEA letter to prescribers.
Removal of DATA Waiver (X-Waiver) Requirement - SAMHSA
Recommendations for Curricular Elements in Substance Use Disorders Training - SAMHSA
Letter to DEA Registrants about MAT Waiver Removal 1/12/2023 - DEA
Letter to DEA Registrants about MATE Training 3/27/2023 - DEA
Addiction Policy and the Consolidated Appropriations Act- ASAM
MAT Act Legislation on Sec 1262, page 3128: FY 2023 Omnibus (Full)
MATE Act Legislation on Sec. 1263, page 3132: Requiring Prescribers of Controlled Substances to Complete Training
In the news
MAT Act: Summary of Solutions Included in the FY 2023 Omnibus – End Substance Use Disorder
Shatterproof Applauds the Passage of the MATE Act to Expand Addiction Education – Business Wire article
The X-waiver for buprenorphine prescribing is gone. It’s time to spread the word - STAT News
President Signs Bipartisan Measure to Improve Addiction Treatment – Pew Trusts
Policies Governing Buprenorphine for Opioid Use Disorder – ASAM update
MAT Act Signed Into Law, NABP Applauds Benefits for Overdose Prevention and Recovery Support – National Association of Boards of Pharmacy
The Maryland Addiction Consultation Service is administered by the University of Maryland School of Medicine and funded by the Maryland Department of Health, Behavioral Health Administration.