Article Figures & Data
Figures
- Figure 1.
Training requirements for Drug Enforcement Agency (DEA) license renewal under the Medication Training and Expansion (MATE) act. Information from reference.4 Abbreviations: FDA, US food and drug administration; SUD, Substance use disorder.
Tables
- Table 1.
Timeline of Buprenorphine as Medication for Opioid Use Disorder (MOUD) Regulatory Changes
1974 Narcotic Addict Treatment Act (NATA) Requires special DEA registration to dispense (but not prescribe) MOUD, creating OTPs (opioid treatment programs). Effectively creates Methadone clinics as they exist today. 2000 DATA (Drug Addiction Treatment Act) 2000 Exempts buprenorphine from OTP regulations. Allows physicians to prescribe buprenorphine as MOUD but requires an 8-hour training, a special registration with the DEA, and limits the number of patients per clinician (or group practice) to 30. Creates the X-waiver program. 2005 to 2006 Amendments to DATA 2000 Remove the group practice limit, introduces 100 patient limits for physicians holding an X-waiver for at least one year (must apply). 2016 CARA (Comprehensive Addiction and Recovery Act) Introduces option for Nurse Practitioners (NP) and Physician Assistants (PA) to apply for a 30-patient X-waiver (with 24 hours of certified training). 2018 SUPPORT (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities) Act Certain physicians holding a 100-patient X-waiver for at least 1 year may apply for a 275-patient limit if their practices meet certain requirements.
NPs and PA’s holding 30-patient X-waiver for 1 year can apply for 100-patient X-waiver.2020 Easy MAT Practitioners can dispense (but not prescribe) up to a 3-day supply of buprenorphine without an X-waiver (useful for Emergency Room clinicians) 2021 Executive Action Physicians, NPs, and PAs are allowed to apply for an X-waiver with a 30-patient limit without the 8- or 24-hour training requirement. 2022 MAT (Mainstreaming Addiction Treatment) and MATE (Medication Training and Expansion) Acts Eliminates the X-waiver program entirely. Buprenorphine is now treated like any other schedule 3 medication when prescribed as MOUD. Institutes new 8-hour addiction treatment training requirement for all clinicians at time of DEA license renewal. Abbreviation: DEA, Drug enforcement agency.
Note: Information from references.3,4,28
