The End of the X-Waiver

Federal officials say change will improve access to treatment for opioid use disorder

January 26, 2023

White House officials this week announced the end of the “X-Waiver,” a move they say will remove barriers to treatment for patients with opioid use disorder.

During an event on Tuesday, White house and federal officials celebrated the end of the DATA-Waiver Program, also known as the X-Waiver requirement. The change allows physicians to prescribe buprenorphine for opioid use disorder—as long as they have their standard registration with the Drug Enforcement Administration (DEA).

“At a time when our nation has experienced 107,000 drug overdose and poisonings in just one year’s time, this change could not have come sooner,” said Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy.

Here’s what you need to know:

• Background:  Millions of Americans live in counties without a single physician waivered to prescribe buprenorphine. Advocates have said the X-waiver requirement presented a clear barrier, separating addiction treatment from the rest of the health care system and creating racial and geographic health disparities. 
• Legislative action:  During December, Congress passed the Consolidated Appropriations Act of 2023, which eliminated the X-Waiver requirement.
• For your information:  During January, the DEA notified all registrants about the change and said it fully supports “this significant policy reform.”
• Training:  The legislation also requires new training requirements for prescribers that will go into effect after June 21, 2023. The DEA said it will provide additional information about those requirements in the near future.
• Quotable:  “While we pause here to recognize the achievement today, we know there is more work to be done,” Dr. Gupta said. “We’ve got to implement the law.”

HAP and Pennsylvania’s hospitals remain committed to advancing treatment and access for substance use disorder and behavioral health care. This includes supporting patients through evidence-based treatment and initiatives to reduce overdose deaths.