DEA and SAMHSA Eliminate X-Waiver Requirements

The Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Administration (SAMHSA) announced the elimination of requirements related to the X-waiver. According to the DEA and SAMHSA announcements, effective immediately:

• Prescriptions for buprenorphine do not require an X-waiver number, only the DEA registration number;
• Limits on the number of patients a practitioner may treat with buprenorphine have been removed; and
• SAMHSA will no longer accept Notices of Intent for X-waiver registration.
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Clinicians, including pharmacists, with a current DEA registration number that includes Schedule III authority may now prescribe buprenorphine for opioid use disorder in accordance with their respective state scope of practice. Pharmacists’ independent prescriptive authority for buprenorphine will continue to be dictated by state scope of practice. Later this year, SAMHSA and DEA plan to propose new training requirements related to prescribing and dispensing of buprenorphine for DEA registration.

The removal of the X-waiver stems from the Mainstreaming Addiction Treatment (MAT) Act, which was recently signed into law. This change was the result of sustained advocacy by ASHP and its members. Special thanks to ASHP members who advocated for this advocacy priority during our Policy Week in Washington, D.C., and to those who wrote to Congress in support of our advocacy.