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OUD Treatment: Biden Administration Expands Ability to Prescribe Buprenorphine

Under the new HHS guidelines, state-licensed, DEA-registered clinicians may apply for a buprenorphine waiver that will allow them to prescribe to up to 30 patients without first meeting statutory certification requirements.

The US Department of Health and Human Services has released new Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder,1 which will allow far more healthcare providers to prescribe buprenorphine, a drug which reduces opioid cravings and withdrawal symptoms. This new policy, effective April 28, 2021, is in response to a tragic 26.8% increase in overdose deaths for the year ending in August 2020, a sad sign that the opioid overdose epidemic is far from over.

Under the new guidelines, state-licensed, DEA-registered clinicians may apply for a waiver that will allow them to prescribe buprenorphine to up to 30 patients without first meeting statutory certification requirements related to training, counseling, and other ancillary services. (Image: iStock)

Under the new Biden administration guidelines, physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives, who are state licensed and registered by the DEA to prescribe controlled substances, may apply for a waiver that will allow them to prescribe buprenorphine to up to 30 patients without first meeting statutory certification requirements related to training, counseling, and other ancillary services. To do so, practitioners will submit a waiver request to the Substance Abuse and Mental Health Services Administration (SAMHSA) and select a patient limit of 30.

Upon approval from SAMHSA, the DEA will issue an X-waiver (previously discussed by PPM) identification number which authorizes the applicant to treat OUD  patients with buprenorphine. While this waiver will eliminate the training requirements which posed a barrier to buprenorphine prescribing, state laws pertaining to supervision requirements and prescription durations will still apply.

This move has been lauded by the healthcare community, with both the American Medical Association (AMA) and American Society of Addiction Medicine quickly praising the change, as it brings with it the potential to greatly increase access to treatment for opioid use disorder (OUD), previously termed opioid addiction, particularly in rural areas who lack access to specialists.2 According to an AMA news release, Dr. Patrice Harris, head of the AMA's opioid task force, the new guidelines will enable more family doctors to include addiction treatment in their day-to-day practice.

Adds Jeremy A. Adler, DMSc, PA-C, DFAAPA, who wrote about data waivers in his recent APP column with Theresa Mallick-Searle, RN-BC, ANP-BC, "We should all applaud when barriers are eliminated that inhibit patient access and choice to effective evidence-based medical care. The new buprenorphine practice guidelines formalized by the Biden administration will save lives, especially at a time when these treatments are needed most."

Mallick-Searle, PPM's resident NP, seconds the American Association of Nurse Practitioners (AANP) comments on the guideline update. AANP stated they are: “pleased that the administration recognizes the important role of NPs in combating the opioid epidemic. These guidelines remove barriers for NPs and other eligible practitioners to provide MAT to patients in need, and we applaud the Administration for these important changes.” Mallick-Searle adds, "Although this is a significant step forward in providing patients the medicated assisted therapy that they need, I would like to continue to stress the importance of duel therapy which includes mental health counseling and treatment, along with free advanced education offerings to new prescribers of buprenorphine for safety and effective outcomes."

 

This brief serves as an update to the following PPM articles:

Authorities Update Opioid and Naloxone Prescribing Policies as Overdoses Soar

Advanced Practice Matters with Theresa & Jeremy: MAT and the DATA Waiver Debate

The Biden Administration Plan for Treating Opioid Use Disorder in the US: Is There One?

 

*Disclaimer: PPM nor its publisher does not support any particular political view on this or other policy matters.

Last updated on: April 30, 2021
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