The U.S. Department of Health and Human Services announced last week it would expand access to medication-assisted treatment (MAT) by exempting physicians from certain certification requirements needed to prescribe buprenorphine to treat opioid use disorder.

Under the new guidelines—Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder— physicians will no longer have to obtain a special federal waiver to prescribe buprenorphine, which is used to treat patients with opioid use disorder.

The California Medical Association (CMA) supports efforts to increase access to much-needed medication-assisted treatment for opioid use disorders. Across the country, many people suffering from opioid use disorder are unable to access medication-assisted treatment for their condition due to a lack of nearby physicians with waivers to prescribe buprenorphine.

More than 83,000 drug overdose deaths occurred in the United States in the 12 months ending in June 2020, the highest number of overdose deaths ever recorded in a 12-month period, and an increase of over 21% compared to the previous year, according to recent provisional data from the Centers for Disease Control and Prevention (CDC). The increase in overdose deaths highlights the need for treatment services to be more accessible for people most at risk of overdose.

The exemption only applies to physicians treating patients in states where they are authorized to practice medicine. Physicians utilizing this exemption will be limited to treating no more than 30 patients with buprenorphine for opioid use disorder at any one time (note: the 30-patient cap does not apply to hospital-based physicians, such as emergency department physicians).

Physicians utilizing this exemption should place an "X" on the prescription and clearly identify that the prescription is being written for opioid use disorders (along with the separate maintaining of charts for patients being treated for OUD).

An interagency working group will be established to monitor the implementation and results of these practice guidelines, as well as the impact on diversion.