HHS Announces Guideline to Expand Access to Opioid Use Disorder Treatment

The US Department of Health and Human Services (HHS) announced it will issue practice guidelines to help expand access to medication-assisted treatment to treat opioid use disorder (OUD).

The new guidelines will address “physician eligibility for a waiver under 21 USC §823(g)(2), in order to increase the availability of buprenorphine,” wrote Secretary of Health and Human Services Alex M. Azar II. Specifically, under these guidelines, physicians with a Drug Enforcement Administration number will no longer be required to apply for a separate waiver, known as the ‘X-waiver’, to prescribe buprenorphine to patients with OUD.

"The medical evidence is clear: access to [MAT], including buprenorphine that can be prescribed in office-based settings, is the gold standard for treating individuals suffering from opioid use disorder," said Adm. Brett P. Giroir, MD, assistant secretary for health, in a press release. "Removing some of the certification requirements for an X-waiver for physicians is a step toward providing more people struggling with this chronic disease access to medication assisted treatment."

In their guideline, the HHS notes:

• The exemption only applies to physicians, not all “qualifying practitioners” defined under 823(g)(2)(G)(iii).
• The exemption applies only to buprenorphine, not methadone.
• Physicians who make use of this exemption must mark an “X” on the prescription and clearly label that the prescription is for the treatment of OUD.
• Physicians using this exemption are limited to treating 30 or fewer patients for OUD at a time. However, this 30-patient limit does not apply to hospital-based physicians, such as physicians in emergency departments.
• Physicians using this exemption can only do so in the state(s) in which they’re authorized to practice medicine.

The guideline is currently under Section 508 review. To view the full guideline, click here.

—Christina Vogt

References:

1. Announcement of practice guidelines for the administration of buprenorphine for treating opioid use disorder. Department of Health and Human Services, Office of the Secretary. January 12, 2021. Accessed January 19, 2021. https://www.hhs.gov/sites/default/files/mat-physician-practice-guidelines.pdf
2. HHS expands access to treatment for opioid use disorder. News release. US Department of Health and Human Services. January 14, 2021. Accessed January 19, 2021. https://www.hhs.gov/about/news/2021/01/14/hhs-expands-access-to-treatment-for-opioid-use-disorder.html