MAT & MATE Acts

When does the removal of the x-waiver go into effect?

As of December 29, 2022.

Are there still limits on how many patients I can prescribe buprenorphine for opioid use disorder?

No, there are no more extended 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 depending on the pharmacy, the dispensing software may still require the x-waiver information to 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.

• The training does not have to occur in one session. It can be cumulative across multiple sessions that equal eight hours of training.
• Trainings can occur in a variety of formats, including classroom settings, seminars at professional society meetings, or virtual offerings, as long as the training is provided by or approved by the organizations specified below.
• Past trainings on the treatment and management of patients with opioid or other substance use disorders can count towards a practitioner meeting this requirement. 
• Past DATA 2000 waiver trainings count towards a DEA registrant’s 8-hour training requirement.

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:

• Treating and managing patients with opioid or other substance use disorders, including the appropriate clinical use of all drugs approved by the Food and Drug Administration for the treatment of a substance use disorder; OR
• Safe pharmacological management of dental pain and screening, brief intervention, and referral for appropriate treatment of patients with or at risk of developing opioid and other substance use disorders.
  Second,

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:

• The American Society of Addiction Medicine
• The American Academy of Addiction Psychiatry
• The American Medical Association
• The American Osteopathic Association
• The American Dental Association
• The American Association of Oral and Maxillofacial Surgeons
• The American Psychiatric Association
• The American Nurses Credentialing Center
• The American Association of Nurse Practitioners
• The American Academy of Physician Associates
• Any other organization accredited by the Accreditation Council for Continuing Medical Education (ACCME) or the Commission for Continuing Education Provider Recognition (CCEPR)
• Any organization accredited by a State medical society accreditor that is recognized by the ACCME or the CCEPR
• Any organization accredited by the American Osteopathic Association to provide continuing medical education
• Any organization approved by the ACCME, or the CCEPR.

For additional information read the DEA letter to prescribers.

• Addiction Policy and the Consolidated Appropriations Act- ASAM
• Letter to DEA Registrants about MAT Waiver Removal 1/12/2023 - DEA
• Letter to DEA Registrants about MATE Training 3/27/2023 - DEA
• Recommendations for Curricular Elements in Substance Use Disorders Training - SAMHSA
• Removal of DATA Waiver (X-Waiver) Requirement - SAMHSA

• 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

• MAT Act Signed Into Law, NABP Applauds Benefits for Overdose Prevention and Recovery Support – National Association of Boards of Pharmacy 
• MAT Act: Summary of Solutions Included in the FY 2023 Omnibus – End Substance Use Disorder
• Policies Governing Buprenorphine for Opioid Use Disorder – ASAM update
• President Signs Bipartisan Measure to Improve Addiction Treatment – Pew Trusts
• The X-waiver for buprenorphine prescribing is gone. It’s time to spread the word - STAT News