WASHINGTON, D.C.—The American Faculty of Emergency Physicians (ACEP) applauds the U.S. Division of Well being and Human Providers’ (HHS) resolution to successfully take away the “X-waiver” requirement for physicians, increasing their capacity to make the most of medication-assisted therapy (MAT) for sufferers fighting opioid use dysfunction (OUD).
“As emergency physicians, we see day by day the devastating results that the opioid disaster has had on the communities we serve—a disaster that has sadly solely worsened in the course of the COVID-19 pandemic,” stated Mark Rosenberg, DO, MBA, FACEP, president of ACEP. “Buprenorphine is a very powerful medicine in our arsenal for treating opioid use dysfunction, which is at present probably the most deadly ailments for People.”
Within the resolution introduced January 14, 2021, HHS issued an exemption to the X-waiver requirement for physicians registered with the Drug Enforcement Administration (DEA) who want to prescribe buprenorphine and different MAT. Whereas the new guidelines pertain to physicians who deal with not more than 30 sufferers with buprenorphine for opioid use dysfunction at anybody time, ACEP appreciates that the division acknowledged the distinctive nature of emergency drugs and determined to not apply this limitation to hospital-based physicians, together with emergency physicians.
The X-waiver presents a serious impediment to “legit” affected person entry to buprenorphine and different MAT. Earlier than at present’s announcement, physicians wishing to prescribe buprenorphine outdoors of opioid therapy applications needed to take an eight-hour course and sometimes waited 60 to 90 days to obtain the waiver as soon as the course is accomplished and the license utility is submitted. The presence of this X-waiver requirement has additionally led to misperception about MAT and has elevated unfavorable preconceived notions about OUD and the therapy of this illness. Consequently, some clinicians are hesitant to pursue this DEA license and even have interaction in therapy of sufferers with OUD.
Eradicating the X-waiver and decreasing stigma to treating OUD within the emergency division has been a serious precedence for ACEP. In January 2020, the Faculty hosted the Summit Addressing the Opioid Stigma within the Emergency Division—an occasion funded by the federal Substance Abuse and Psychological Well being Providers Administration as a part of its Opioid Response Community by which stakeholders recognized methods and behaviors to scale back practices that perpetuate stigma within the emergency division. ACEP additionally despatched a letter to HHS as an example the challenges of the X-waiver and supported H.R. 2482, the “Mainstreaming Habit Remedy Act of 2019,” which might get rid of the waiver requirement.
Added Dr. Rosenberg, “It is a nice day for our sufferers. The X-waiver was an outdated and cumbersome barrier to therapy, and it exacerbated stigma for these fighting opioid use dysfunction. Now, greater than ever, we’d like compassion and motion in treating sufferers with dependancy.”