New HHS guidelines allow nearly all healthcare providers to prescribe buprenorphine

HHS on April 27 released new guidelines on prescribing practices for buprenorphine, a drug that treats opioid addiction and chronic pain. They allow most healthcare providers to prescribe the drug without undergoing a separate training or having to apply for a waiver.

Before the updated guidelines, physicians seeking to prescribe buprenorphine outside of opioid treatment programs were required to complete an eight-hour course, often waiting 60 to 90 days to receive their waiver once the course was completed.

The effort to make buprenorphine prescription easier began in January, under the administration of then-President Donald Trump. HHS said Jan. 14 it would update its guidelines to waive the training and waiver requirements. However, when President Joe Biden took office, legal experts warned the administration that HHS is not authorized to issue guidelines that allow physicians to avoid requirements Congress mandated, so the move was canceled.

The new guidelines released April 27 allow physicians, nurse practitioners, physician assistants, clinical nurse specialists, certified nurse anesthetists and certified nurse midwives to treat up to 30 patients with buprenorphine. These providers still need to submit a notice of intent to the Substance Abuse and Mental Health Services Administration stating their intention to prescribe the drug, but they're now exempt from the training requirement. 

The Mainstreaming Addiction Treatment Act, a separate bill seeking to fully eliminate the waiver requirement authored by Rep. Paul Tonko, D-N.Y., is pending before Congress.

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