{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T17:44:16Z","timestamp":1782668656095,"version":"3.54.5"},"reference-count":16,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Penn State Inter-Campus Health and Medicine Research Program"},{"DOI":"10.13039\/100006108","name":"national center for advancing translational sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"national institutes of health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinical and Translational Science Award","award":["UL1 TR002014"],"award-info":[{"award-number":["UL1 TR002014"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>To expand access to buprenorphine treatment for opioid use disorder (OUD), the X-waiver requirement was removed in January 2023. This study examined changes in OUD diagnosis and buprenorphine prescribing before and after waiver elimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis using TriNetX electronic health record data (EHR) on adults with OUD during the waiver-required (2021-2022) and elimination (2023-2024) periods. Logistic regression estimated the likelihood of new OUD diagnoses and buprenorphine initiation, adjusting for demographic and clinical characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 1\u2009041\u2009754 adults with an OUD diagnosis (516\u2009508 in the waiver-required and 525\u2009246 in the waiver-elimination periods), 295\u2009675 participants (146\u2009904 in the waiver-required and 148\u2009771 in the waiver-elimination periods) had a new OUD diagnosis recorded. Among those with a new OUD diagnosis, buprenorphine was prescribed to 27\u2009665 (18.8%) participants in the waiver-required and 29\u2009223 (19.6%) participants in the waiver-elimination periods. Those in the waiver-elimination period, compared to those in the waiver-required period, were 2% less likely to receive a new OUD diagnosis (adjusted odds ratio [aOR]\u2009=\u20090.98, 95% confidence interval [CI]: 0.97, 0.98) and 14% more likely to have buprenorphine initiated (aOR\u2009=\u20091.14, 95% CI: 1.12, 1.16).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this retrospective analysis of a large EHR dataset, we found that following the elimination of the X-waiver, the incidence of new OUD diagnoses declined by 2%, while subsequent buprenorphine initiation increased by 14%. These findings highlight the impact of regulatory changes on buprenorphine prescribing and underscore the need for continued efforts to reduce barriers to this life-saving treatment for OUD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342251414541","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T03:45:22Z","timestamp":1769831122000},"page":"747-753","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the Initial Impact of X-Waiver Elimination on Buprenorphine Prescribing for Opioid Use Disorder"],"prefix":"10.1177","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3939-8979","authenticated-orcid":false,"given":"Wen-Jan","family":"Tuan","sequence":"first","affiliation":[{"name":"Departments of Family and Community Medicine and Public Health Science, Penn State College of Medicine, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujeong","family":"Park","sequence":"additional","affiliation":[{"name":"School of Public Affairs, Penn State Harrisburg, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shazib","family":"Altaf","sequence":"additional","affiliation":[{"name":"School of Public Affairs, Penn State Harrisburg, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra E.","family":"Zgierska","sequence":"additional","affiliation":[{"name":"Departments of Family and Community Medicine, Anesthesiology and Perioperative Medicine, and Public Health Science, Penn State College of Medicine, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2021.1903659"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302664"},{"key":"e_1_3_2_4_2","unstructured":"U.S. Congress. Drug Addiction Treatment Act of 2000 (DATA). Accessed November 24 2023. https:\/\/www.congress.gov\/bill\/106th-congress\/house-bill\/2634"},{"issue":"131","key":"e_1_3_2_5_2","first-page":"44711","article-title":"Medication assisted treatment for opioid use disorders. Final rule","volume":"81","author":"Substance Abuse and Mental Health Services Administration, HHS","year":"2016","unstructured":"Substance Abuse and Mental Health Services Administration, HHS. Medication assisted treatment for opioid use disorders. Final rule. Fed Regist. 2016;81(131):44711-44739.","journal-title":"Fed Regist"},{"key":"e_1_3_2_6_2","unstructured":"U.S. Substance Abuse and Mental health Services Administration. Waiver Elimination (MAT Act). March 31 2023. Accessed October 18 2023. https:\/\/www.samhsa.gov\/medications-substance-use-disorders\/waiver-elimination-mat-act#:~:text=Section%201262%20of%20the%20\u2019Consolidated%20Appropriations%20Act%20of%202023\u2019%20removes treatment%20of%20opioid%20use%20disorder"},{"key":"e_1_3_2_7_2","unstructured":"U.S. Substance Abuse and Mental health Services Administration. Training requirements (MATE Act) resources. March 31 2023. Accessed November 25 2023. https:\/\/www.samhsa.gov\/medications-substance-use-disorders\/training-requirements-mate-act-resources"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2312906"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2011-000116"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.1982"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.12419"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06257-4"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.18493"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa2212412"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/add.16338"},{"key":"e_1_3_2_17_2","unstructured":"US Department of Veterans Affairs. VA\/DOD clinical practice guidelines. May 15 2022. Accessed November 11 2025. https:\/\/www.healthquality.va.gov\/guidelines\/pain\/cot\/"}],"container-title":["Substance Use &amp; Addiction Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342251414541","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/29767342251414541","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342251414541","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T16:46:17Z","timestamp":1782665177000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/29767342251414541"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/29767342251414541"],"URL":"https:\/\/doi.org\/10.1177\/29767342251414541","relation":{},"ISSN":["2976-7342","2976-7350"],"issn-type":[{"value":"2976-7342","type":"print"},{"value":"2976-7350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,30]]}}}