DEA X-Waiver, Ended

Good news for the new year: The DEA X-Waiver program , also known as a DATA-Waiver, has officially ended. On December 29, 2022, Congress passed the Omnibus bill (Consolidated Appropriations Act), which included the Mainstreaming Addiction Act and officially ended the requirement for the special waiver. Any person holding a DEA license that includes Schedule III medications may now prescribe buprenorphine and other similar medications for opioid use disorder.

Multiple physician organizations joined together to push for repeal or revision of the X-Waiver program requirements since its inception. These organizations were primarily concerned that limiting the prescription of these medications significantly hindered efforts nationwide to improve access to opioid use disorder treatment. Thanks to their efforts, the program waiver requirements were repealed.

The Omnibus bill also included the Medication Access and Training Expansion (MATE) Act. This bill requires opioid-prescribing practitioners to complete 8 hours of “training with respect to the treatment and management of patients with opioid or other substance use disorders” with every DEA license renewal. The bill provides exceptions to the training for physicians holding board certification in:

• Addiction psychiatry or addiction medicine by the American Board of Medical Specialties
• Board certification by the American Board of Addiction Medicine
• Board certification in addiction medicine by the American Osteopathic Association.

Although multiple organizations were in favor of the MATE act, the AMA opposed the legislation, noting:

“… the AMA has long-standing policy opposing federal intervention or mandates on educational standards for physicians, especially as a condition of licensure. The mandate also directly interferes with state licensing and professional accrediting bodies that have responsibility to design and implement appropriate educational standards for the training of physicians.”

Despite advocacy efforts by the AMA against the MATE act, the bill was included in the final legislation. This training requirement begins on June 21, 2023.

The DEA sent a letter to all registered practitioners, noting that:

• “A DATA-Waiver registration is no longer required to treat patients with buprenorphine for opioid use disorder.”
• “Going forward, all prescriptions for buprenorphine only require a standard DEA registration number. The previously used DA TA-Waiver registration numbers are no longer needed for any prescription.”
• “There are no longer any limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine.”
• “The Act does not impact existing state laws or regulations that may be applicable.”

Accordingly, the Substance Abuse and Mental Health Services Administration (SAMHSA) has stopped accepting applications for the waiver and now reflects the new legislation on their website. SAMHSA also notes that further information regarding the education requirements will be released prior to the June 21, 2023 deadline.

For Further Reading:

PEMP Jan 2023  

Responsible and Safe Use of Opioids in Children and Adolescents in the Emergency Department (Pain Management CME, Controlled Substances CME, Pharmacology CME, and Addiction Disorders CME) 

EMP June 2022 

Procedural Sedation and Analgesia in the Emergency Department (Pharmacology CME)   

PEMP May 2022 

Ultrasound-Guided Pediatric Nerve Blocks in the Emergency Department: An Evidence-Based Update (Pain Management CME and Pharmacology CME) 

Trauma Extra Dec 2021 

Acute Traumatic Wounds: Evaluation, Cleansing, and Repair in the ED – Trauma EXTRA Supplement (Trauma CME and Pharmacology CME) 

PEMP June 2020 

Optimizing Emergency Management to Reduce Morbidity and Mortality in Pediatric Burn Patients (Trauma CME) 

EMP November 2019 

Emergency Department Pain Management: Beyond Opioids 

PEMP August 2019 

Pediatric Pain Management in the Emergency Department