Increased Access To Buprenorphine (Suboxone) In 2021: What This Means For Opioid Addiction Recovery

Access to buprenorphine has expanded dramatically in recent years. Following decades of restrictive federal requirements, the January 2023 elimination of the X-waiver has made buprenorphine prescribing available to virtually any licensed healthcare provider in the U.S. Here’s what changed and what it means for people seeking treatment.

Buprenorphine is a gold-standard treatment for opioid use disorder, and the medication can:

• reduce opioid cravings
• reduce the risk of overdose
• improve quality of life outcomes in recovery

What Has Changed: From 2021 Reforms To Full X-Waiver Elimination

On Tuesday, April 27, 2021, the U.S. federal government issued several changes to requirements for prescribing buprenorphine, also known as Suboxone.

Training Requirements For Prescribing Buprenorphine

New guidelines from the U.S. Department of Health and Human Services have eased training requirements for who can prescribe buprenorphine.

Previously, prescribing buprenorphine for opioid use disorder required that physicians undergo eight hours of specialized training—a requirement first mandated under the Drug Addiction Treatment Act of 2000.

According to addiction medicine experts, this has historically reduced access to buprenorphine for people with opioid use disorder, especially in rural areas where there are fewer prescribers.

Who can now prescribe buprenorphine:

As of January 2023, any DEA-licensed healthcare provider with Schedule III prescribing authority can prescribe buprenorphine for OUD with no special training, no waiver application, and no patient caps. This includes primary care physicians, nurse practitioners, physician assistants, emergency medicine physicians, OB/GYNs, and telehealth providers.

What Is Buprenorphine And Why Is It Prescribed?

Buprenorphine is an opioid-based medication used to treat OUD. It is commonly used within medication-assisted treatment programs for opioid use disorder.

Buprenorphine comes in the form of a film or tablet. For people with OUD, it can help reduce opioid cravings, which are a common trigger for relapse.

Common opioids of misuse include:

• oxycodone (OxyContin)
• heroin
• hydrocodone (Vicodin)
• hydromorphone (Dilaudid)
• fentanyl

Buprenorphine, particularly Suboxone—the brand name for buprenorphine with naloxone—is an evidence-based treatment for OUD that can be safe and effective for long-term use.

Benefits Of Increased Access To Buprenorphine

Buprenorphine is one of the leading treatments for opioid addiction and can help people maintain their recovery, particularly in the early stages when cravings can be stronger.

Benefits of increasing access to buprenorphine include:

• increasing the number of people who can receive it
• increased treatment retention
• reduced barriers to effective treatment
• improved quality of life outcomes
• reduced risk for opioid overdose
• increased opportunity for long-term recovery

Drug overdose deaths have reached record highs in recent years, with the CDC recording more than 110,000 annually. The majority involve opioids, primarily illicitly manufactured fentanyl.

About 70 percent of all drug overdose deaths in the United States—tens of thousands of deaths each year—involve opioids.

Increasing access to addiction treatments like buprenorphine can be not only life-changing for people with addiction but also life-saving.

Who Can Benefit From Increased Access To Buprenorphine?

Expanding access to buprenorphine has the potential to benefit anyone who is either actively addicted to opioids or is in opioid addiction recovery.

These guidelines may also expand buprenorphine access for people who have historically had a more difficult time acquiring it, despite having a clear need.

This can include:

• rural residents
• incarcerated populations
• residents of areas with few prescribers
• people without a regular primary care provider
• people who prefer telehealth or remote care
• people who previously couldn’t find a waivered provider in their area

Addiction researcher Brendan Saloner of the Johns Hopkins Bloomberg School of Public Health told Associated Press that these new guidelines would “provide more on-ramps to treatment,” particularly in settings where people most commonly show up for treatment.

Finding Buprenorphine Treatment

Browse our directory or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about addiction recovery.

Written by the Addiction Resource Editorial Staff