{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T02:16:17Z","timestamp":1792548977534,"version":"4.5.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>The 2023 Consolidated Appropriations Act repealed the special waiver for prescribing buprenorphine to patients with opioid use disorder, a bipartisan goal long sought by advocates. The change has symbolic importance in recognizing that buprenorphine is a mainstream medical treatment. We argue that the maximum potential of the law can be achieved by addressing three bottlenecks. First, it is important that new training requirements for all controlled substances prescribers be grounded in scientific principles of addiction treatment and are robustly evaluated to ensure they meet quality standards. Second, even with the elimination of the waiver, there are potential constraints from state law such as state-specific requirements that practitioners require counseling or obtain a separate credential, and many states also have limiting scope of practice regulations. We recommend that these requirements are eased wherever possible to improve treatment access. Third, it is critical to build onramps to treatment in settings such as primary care, hospitals, and correctional facilities. While we anticipate that buprenorphine prescribing will primarily occur in high-volume practices, there is the potential to activate a broader workforce to serve as entry points to care. We conclude that the stage is set for significant increases in lifesaving treatment but the difficult task ahead is ensuring that the resources and training are available to build strong capacity.<\/jats:p>","DOI":"10.1177\/08897077231186212","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T07:35:23Z","timestamp":1694072123000},"page":"108-111","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Will the End of the X-Waiver Expand Access to Buprenorphine Treatment? Achieving the Full Potential of the 2023 Consolidated Appropriations Act"],"prefix":"10.1177","volume":"44","author":[{"given":"Brendan","family":"Saloner","sequence":"first","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-6369","authenticated-orcid":false,"given":"Barbara","family":"Andraka-Christou","sequence":"additional","affiliation":[{"name":"School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley D.","family":"Stein","sequence":"additional","affiliation":[{"name":"RAND Corporation, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2453-8871","authenticated-orcid":false,"given":"Adam J.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"bibr1-08897077231186212","unstructured":"Consolidated Appropriations Act\n                      . 2023. Accessed July 4, 2023. Accessed July 4, 2023. https:\/\/www.appropriations.senate.gov\/imo\/media\/doc\/JRQ121922.PDF"},{"key":"bibr2-08897077231186212","unstructured":"Drug Enforcement Administration. MATE Training Letter. March 27, 2023. Accessed July 4, 2023. https:\/\/deadiversion.usdoj.gov\/pubs\/docs\/MATE_Training_Letter_Final.pdf"},{"key":"bibr3-08897077231186212","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-07102-y"},{"key":"bibr4-08897077231186212","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.1102"},{"key":"bibr5-08897077231186212","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2019.1694617"},{"key":"bibr6-08897077231186212","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000863"},{"key":"bibr7-08897077231186212","unstructured":"Substance Abuse and Mental Health Services Administration. Medications for Opioid Use Disorder. Treatment Improvement Protocol (TIP) Series 63, Full Document. 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