Get Waivered—and USE IT!
In a 12 month study done in 2019, less than 35% of adults in the U.S. struggling with OUD were found to be receiving treatment.1 Less than 10% of primary care doctors have a waiver to prescribe buprenorphine.2 Nationally, only approximately half of providers with a waiver to prescribe buprenorphine actually use it.3 Despite the clear evidence that treatment works, many patients are left without the support that they need to recover. One way to address this is to have more healthcare providers engaged in the treatment of opioid use disorder. Here’s how you can join the fight!
Physicians can treat up to 30 patients at a time by simply submitting a buprenorphine waiver application (a.k.a. notification of intent) to the Substance Abuse and Mental Health Services Administration (SAMHSA) prior to dispensing or prescribing buprenorphine. No additional training is needed. There is also no requirement to provide counseling or other ancillary services. The time spent treating patients under this training exemption does not apply toward increased patient limits in the future.
Physicians may also elect to take an 8-hour buprenorphine treatment course. By doing so, they are eligible to apply to treat up to 30 patients at a time for their first year, then may apply to increase their patient volume to 100 patients for the following year.
Physicians who take the training course may also be eligible to treat up to 100 patients at a time their first year by meeting one of the following two requirements:
- The physician holds a board certification in addiction medicine or addiction psychiatry by the American Board of Preventive Medicine or the American Board of Psychiatry and Neurology
- The practitioner provides medication-assisted treatment (MAT) in a “qualified practice setting.” A qualified practice setting is a practice setting that:
- provides professional coverage for patient medical emergencies during hours when the practitioner’s practice is closed;
- provides access to case-management services for patients including referral and follow-up services for programs that provide, or financially support, the provision of services such as medical, behavioral, social, housing, employment, educational, or other related services;
- uses health information technology systems such as electronic health records;
- is registered for their State prescription drug monitoring program (PDMP) where operational and in accordance with Federal and State law; and
- accepts third-party payment for costs in providing health services, including written billing, credit, and collection policies and procedures, or federal health benefits.
After one year at the 100-patient limit, qualifying practitioners who meet the above criteria can apply to increase their patient limit to 275. In addition, 42 CFR 8.655 defines circumstances in which qualifying practitioners may request a temporary increase to treat up to 275 patients to address emergency situations for six months.
STAY TUNED: The Restoring Hope for Mental Health and Well-Being Act of 2022 has passed in Congress which may obviate the need for a waiver to prescribe buprenorphine! Next, it’s on to the Senate!
Click the link to access your buprenorphine waiver course:
- Physician Buprenorphine Waiver Training– 8-hour training
- Nurses Buprenorphine Waiver Training(NPs, CNSs, CRNAs, CNMs) – 24-hour training
- Physician Assistant Buprenorphine Waiver Training– 24-hour training
To learn more about getting waivered check out:
- Become a Buprenorphine Waivered Practitioner | SAMHSA
- FAQ for Buprenorphine Waiver Applicants and Certified Practitioners | SAMHSA
- FAQs About the New Buprenorphine Practice Guidelines | SAMHSA
1Jones CM, McCance-Katz EF. Co-occurring substance use and mental disorders among adults with opioid use disorder. Drug Alcohol Depend. 2019 Apr 1;197:78-82. doi: 10.1016/j.drugalcdep.2018.12.030. Epub 2019 Feb 14. PMID: 30784952.
2Ryan K. McBain, Andrew Dick, Mark Sorbero, et al; Growth and Distribution of Buprenorphine-Waivered Providers in the United States, 2007–2017. Ann Intern Med.2020;172:504-506. [Epub 7 January 2020]. doi:10.7326/M19-2403
3Duncan A, Anderman J, Deseran T, Reynolds I, Stein BD. Monthly Patient Volumes of Buprenorphine-Waivered Clinicians in the US. JAMA Netw Open. 2020;3(8):e2014045. doi:10.1001/jamanetworkopen.2020.14045