They Have Xed the X Waiver!


Dear IEPC members and friends

The U.S. Department of Health and Human Services recently announced that it will expand access to medication-assisted treatment (MAT) by exempting physicians from certain certification requirements needed to prescribe buprenorphine for patients suffering from opioid use disorder.

The emergency and addiction community are celebrating the removal of this treatment barrier. Read the announcements from HHS and ACEP.

There were 1 million physicians who could prescribe opioids, but only 66,000 who could prescribe treatment for opioid use disorder. This imbalance is now changed. The barrier lift comes at the heels of the 2020 grim overdose data. We have a historic high of 83,000 overdose deaths representing a 21% increase. Fentanyl deaths accounted for nearly 45% increase. 

Prescribing buprenorphine does require some guidance that can be learned. One resource on prescribing buprenorphine is available from the National Clinical Consultation Center. This is the same group that provided consultation for HIV prophylaxis medication. They are able to provide physician to physician support Monday – Friday 6 am – 5 pm PST at 855-300-3595.

I have been working on Xing the X-Waiver for a year – from changing the hearts and minds of leaders in Washington DC, to writing action memos, and engaging the media. Thank you to IEPC members who have supported this effort. A special shout out to the American College of Emergency Physicians for writing and changing letters at a moment’s notice, and to my friends Liz Connely and Libby Jones from the Pew Foundation or their relentless advocacy and support.

A big thank you to Director Jim Carroll of ONDCP, America’s Drug Czar, who is the one who really pushed to make this happen. He was supported by Dr. Nora Volkow Director of NIDA, and ADM Dr. Brett Giroir, Assistant Secretary for Health. 

Eliminating the X waiver will not eliminate addiction or overdoses. But it is a step in the right direction for addiction treatment. Listen to this special episode of High Truths that addresses the Xwaiver and gives a shout out to IEPC.

Thank you to all the heroes on the front lines – treating COVID, treating addiction, and anything that comes to your door.

Roneet Lev, MD
Executive Director, IEPC