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Updates to Buprenorphine Prescribing & Substance Use Training from the Consolidated Appropriations Act (CAA), 2023

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.

MAT Act: Removes the waiver requirement to prescribe buprenorphine for opioid use disorder

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. - SAMHSA update

MATE Act: Requires prescribers of controlled substances to complete an 8-hour SUD training upon renewing or receiving their DEA license

SAMHSA and DEA are actively working on implementation of a separate provision of the Omnibus related to training requirements for DEA registration that becomes effective June 21, 2023. - SAMHSA update

Get started providing access to lifesaving care: Expanding Access to Buprenorphine

Primary guidance

SAMHSA: Removal of DATA Waiver (X-Waiver) Requirement 

DEA: Letter to DEA Registrants 

ASAM Webinar recording and resources: Addiction Policy and the Consolidated Appropriations Act

Frequently Asked Questions

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.

When does the mandatory training for all DEA licensed prescribers go into effect?

June 21, 2023.

More information about the MAT and MATE Acts

MAT Act Legislation on Sec 1262, page 3128: FY 2023 Omnibus (Full) 

MAT Act: Summary of Solutions Included in the FY 2023 OmnibusEnd Substance Use Disorder

MATE Act Legislation on Sec. 1263, page 3132: Requiring Prescribers of Controlled Substances to Complete Training

MATE Act Overview: 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 TreatmentPew Trusts

Policies Governing Buprenorphine for Opioid Use DisorderASAM 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.