The End of the X-Waiver: Not a Moment Too Soon!

The X-waiver requires a physician to obtain specific training and federal certification to prescribe buprenorphine to treat opioid use disorder (OUD). Outgoing President Donald Trump issued an order that would have exempted many physicians from the X-waiver, but incoming President Biden stated they would repeal the Trump order despite campaign promises to better treat OUD. Opioid rehabilitation is a big business and a complex one, but there are not enough places in rehabilitation programs to meet demand, which is increasing year after year. In many cases, the X-waiver makes it more difficult and imposes more limitations on physicians to offer buprenorphine maintenance therapy than opioid prescribing. The Biden administration recently announced that it will not block the Trump orders, but rather will get rid of the X-waiver. The authors hope this is a permanent move away from the antiquated X-waiver. Further, this would provide greater access to accessible, affordable, and evidence-based OUD treatment to more patients, and may help break down some healthcare disparities in the treatment of drug disorders.