Mainstreaming Addiction Treatment Act Revived in Congress

A bill to expand access to medication-assisted treatment for substance use disorders has been reintroduced by a bipartisan group of legislators in both houses of Congress.

If approved, the Mainstreaming Addiction Treatment (MAT) Act will eliminate the requirement that practitioners obtain a separate “X-waiver” through DEA to prescribe buprenorphine for SUD treatment. The bill would also require the secretary of HHS to develop a campaign that would educate practitioners about the change and encourage providers to integrate SUD treatment into their practices.

The bill is sponsored by:

• Rep. Paul Tonko (D-NY)
• Rep. Antonio Delgado (D-NY)
• Rep. Anthony Gonzalez (R-OH)
• Rep. Mike Turner (R-OH)
• Sen. Maggie Hassan (D-NH)
• Sen. Lisa Murkowski (R-AK)

In January, HHS under the Trump administration announced its intentions to eliminate the X-waiver as part of its updated Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder. Two weeks later, however, the Biden administration halted those plans amid legal and clinical concerns.

The MAT Act was first introduced in July 2019 and received support from more than 100 members of Congress. Several treatment industry groups voiced their approval of the bill’s revival this week. People's Action, VOCAL-NY, the Drug Policy Alliance and the National Harm Reduction Coalition on Thursday released a joint statement that lauded the bill for removing “redundant and outdated barriers for healthcare providers to prescribe life-saving medicines.”

Paul H. Earley, MD, president of the American Society of Addiction Medicine, said removing the X-waiver is “one piece of the puzzle towards addressing the country’s addiction and overdose crisis,” adding that “[s]imultaneously, the nation needs bold, coordinated policies that ensure prescribers of any controlled medication, not just buprenorphine, receive baseline education and training on how to identify and care for Americans with substance use disorder using evidence-based treatments.”

Erin Shanning, president of End SUD, a campaign to advance policies to prevent and treat substance use disorder, said in a statement that the MAT Act “is a common-sense solution to the overdose crisis that will increase participation in treatment, help eliminate stigma, and reduce healthcare and criminal justice costs.”

In a statement, the National Association of Boards of Pharmacy noted removing the X-waiver will allow pharmacists to “help develop treatment plans, communicate with patients, coordinate care and monitor adherence and improvement, along with prescribing and dispensing buprenorphine medications.”

Also, a coalition of 44 healthcare, behavioral health, recovery, harm reduction, criminal justice and social advocacy groups in New Jersey collaborated on a letter calling on the state’s Congressional delegation to pass the bill.