Government Rescinds Proposed Regulatory Change Affecting Buprenorphine Waivers

The Biden administration has rescinded changes proposed in the last days of the Trump administration that would have expanded the ability of practitioners to prescribe buprenorphine.

The proposed changes to the “X-Waiver Program” under the Drug Addiction Treatment Act of 2000 would have eliminated the need for physicians to acquire a waiver for office-based buprenorphine treatment of patients with opioid use disorder. It would have applied only to physicians limited to treating no more than 30 patients. But the Biden administration said such a regulatory change is not legally possible without changes to the statutory language of the Children’s Health Act of 2000, which established the program. Declaring the January 14 announcement in the Federal Register (six days before the inauguration of Joe Biden) “premature,” the White House nevertheless pledged to increase practitioner access to buprenorphine.

The APA Resource Document on Education and Training in Substance Use Disorders, released last October (Psychiatric News), calls for psychiatry residents to receive X-waiver training. There is a SAMHSA grant program for universities to implement the training (see Provider’s Clinical Support System – Universities).

The document also offers recommendations for medical schools, residency programs, and continuing medical education for practicing physicians to increase the pool of physicians trained to treat patients with substance use disorder. ■