X-Waiver No Longer Needed but DEA Implements New Education Requirements

The x-waiver requirement, which restricted who may treat patients with buprenorphine for opioid use disorder, will be officially rescinded effective June 21, 2023. The Consolidated Appropriations Act of 2023 removes the requirement, and there will no longer be any limits or caps on the number of patients that a prescriber may treat for opioid use disorder with buprenorphine (existing state laws and regulations will remain in effect). Prescribers will only need a DEA registration number to treat patients for OUD.

While the x-waiver will no longer be required to treat OUD, new or renewing DEA registrants will be required to have met at least one of the following criteria effective June 27, 2023:

  • Eight hours of training on opioid or other substance use disorders;
  • Board certification in addiction medicine or addiction psychiatry from the American Board of Medical Specialties, American Board of Addiction Medicine, or the American Osteopathic Association; or
  • Graduation within five years and status in good standing from medical, advanced practice nursing, or physician assistant school in the United States that included successful completion of an opioid or other substance use disorder curriculum of at least eight hours.

FDA Updates Prescribing Information for IR and ER/LA Pain Medicines

The FDA is requiring several updates to the prescribing information for both immediate-release (IR) and extended release/long acting (ER/LA) opioid pain medicines. Updates for patients, parents, and caregivers include information on taking opioid medications exactly as prescribed, safe and secure storage, seeking help in the event of respiratory problems, and talking to health care professionals about the benefits of naloxone and how to obtain it. Health care professionals are advised to: prescribe the lowest effective dose of an IR opioid for the shortest duration of time to reduce the risks associated with these products; reserve ER/LA opioid pain medicines only for severe and persistent pain that requires an extended treatment period with a daily opioid pain medicine and for which alternative treatment options are inadequate; discuss naloxone with patients; and more.

NAM Hosts 4-Part Series on Improving Telehealth and Virtual Care for Pain Management and Substance Use Disorders

In an effort to better understand both the challenges and opportunities for telehealth and virtual care within the pain management and SUD care ecosystems, the Opioid Action Collaborative’s Working Groups on Pain Management Guidelines and Evidence Standards (PM) and Prevention, Treatment, and Recovery Services (PTR) convened a four-party meeting series as a forum to explore both the barriers and opportunities for expanding telehealth and virtual care services in pain management and OUD/SUD care. The series has worked to identify key barriers and opportunities for expanding telehealth and virtual care services for pain and OUD/SUD, including actionable and evidence-informed guidance that can support future decision-making by policymakers, regulators, payers, health systems, clinicians, and patients.