Breaking Down Barriers: Expanded Access to Medication for Opioid Use Disorder

The Substance Abuse and Mental Health Services Administration (SAMHSA) 2021 National Survey on Drug Use and Health estimated that 9.2 million people ages 12 and older had misused opioids in the past year.[1] Death by overdose continues to be a leading cause of injury-related death in the United States, with a nearly 15% increase in drug overdose deaths from 2020 to 2021.[2]

On December 29, 2022, President Biden signed into law an act that will significantly increase access to medication for opioid use disorder (MOUD). Part of the 2023 Consolidated Appropriations Act (P.L. 117-328), the amended Controlled Substances Act (the “Act”) contains provisions that better align with the Department of Health and Human Services (HHS) Overdose Prevention Strategy and enable qualified practitioners to prescribe medications like buprenorphine, naltrexone, and methadone, medications used to treat opioid use disorder and dependence. Addressing the mental health crisis and drug overdose epidemic through investments in prevention, treatment, and recovery remains integral to the Biden Administration’s Unity Agenda.

Special Waiver Requirement Eliminated

The updated provisions terminated a long-standing requirement promulgated by the 2000 Drug Abuse Treatment Act (DATA) for practitioners to obtain a special waiver to prescribe medications like buprenorphine for treating opioid use disorder (commonly referred to as a DEAx number). Despite MOUD’s demonstrated efficacy, access has been historically limited due to barriers at many levels, including individual, clinic, and system levels. The elimination of the waiver requirement intends to create greater access to necessary life-saving medication. The patient limits associated with the waiver will no longer be applicable as a result of the Act.

Note: While eligible providers need not apply for a separate waiver, all who obtain or renew controlled substances licenses from the Drug Enforcement Agency (DEA) will be required to participate in eight hours of substance use disorder training, with certain exceptions.

Moving Forward

As a result of the waiver elimination, SAMHSA is encouraging all eligible practitioners – as permissible under state law – to screen patients for opioid use disorders and offer access to buprenorphine or other MOUD. With deaths by overdose remaining a national crisis, eligible practitioners must be adequately equipped with the tools, training, and access to life-saving medication. Expanding access to MOUD is a step in the right direction for practitioners to better address the opioid overdose and addiction crisis in the United States.

[1] SAMHSA Announces National Survey on Drug Use and Health (NSDUH) Results Detailing Mental Illness and Substance Use Levels in 2021, SAMHSA, January 4, 2023,

[2] Press Release, U.S. Overdose Death in 2021 Increased Half as Much as in 2020 – But Are Still Up 15%, Centers for Disease Control and Prevention, May 11, 2022,’s%20National,93%2C655%20deaths%20estimated%20in%202020.

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About the Author

An attorney in the firm’s Troy office, Allison Tuohy practices in all areas of healthcare law, with a particular interest in mergers and acquisitions, and represents a variety of healthcare professionals and organizations. She can be reached at 248-433-7505 or Her biography can be accessed here.