Instead, it not only slid under the media radar but hasn’t been communicated to the people who need to know about it.
Included in the end-of-year appropriations bill that President Biden signed on December 29, 2022 was the bipartisan Mainstreaming Addiction Treatment (MAT) Act of 2023.
This act eliminates the so-called X-waiver that physicians had long needed to prescribe buprenorphine, a medication that curbs opioid cravings, reduces drug use, and prevents deaths among people who use opioids.
Before the MAT Act, the U.S. Drug Enforcement Agency required clinicians who wanted to prescribe buprenorphine for the treatment of opioid use disorder to undergo an extensive training and registration process for the “X-waiver,” so named because, upon completion, an “X” was added to the clinician’s DEA registration number.
This time-consuming process erected a barrier that discouraged doctors from prescribing buprenorphine for opioid use disorder.
The waiver also contributed to the ongoing stigma around both opioid use disorder and buprenorphine, because while any physician can prescribe buprenorphine for chronic pain without a special waiver, the specter of “abusers” who might sell or in some way misuse this pharmaceutical meant that only specially trained experts could be trusted to prescribe buprenorphine for opioid use disorder.
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