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Understanding changes in buprenorphine prescribing regulation","","Opioid use disorder remains a major public health challenge in the United States. Buprenorphine is an FDA-approved medication for opioid use disorder associated with reduced opioid-related mortality and morbidity. A brief report traces the regulatory history of buprenorphine prescribing, explains recent changes under the 2023 Consolidated Appropriations Act, and evaluates implications for nurse practitioner prescribing. It concludes by emphasizing the need to promote buprenorphine access.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/what-the-x-understanding-changes-in-buprenorphine-prescribing-regulation/328305/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/what-the-x-understanding-changes-in-buprenorphine-prescribing-regulation/328305.png","ImageObject",300,407,{"name":92,"@type":93},"นรินทร์","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What did buprenorphine prescribing regulation require before January 2023?","Question",{"text":113,"@type":114},"Before January 2023, providers generally needed a DEA X waiver to prescribe buprenorphine for opioid use disorder.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What changes were introduced by the 2023 Consolidated Appropriations Act?",{"text":118,"@type":114},"The 2023 Consolidated Appropriations Act removed the DEA X waiver requirement and implemented new training requirements for new and renewing DEA registrants.",{"name":120,"@type":111,"acceptedAnswer":121},"Why does the report emphasize promoting buprenorphine access?",{"text":122,"@type":114},"The report concludes that supporting access to buprenorphine therapy is important for addressing opioid use disorder treatment needs.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},328305,1790287236,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":52},2336475104957,"https://ap-avatar.wpscdn.com/avatar/22000c4c6bd8a5076e1?x-image-process=image/resize,m_fixed,w_180,h_180&k=1787554080175789136","Brief Report  \nDownloaded from [http://journals.lww.com/jaanp by 7kK4iY3JasnTW0kvrmpo IFMgelYWnBLMO](http://journals.lww.com/jaanp by 7kK4iY3JasnTW0kvrmpo IFMgelYWnBLMO)+0GESVKQdaWUD+YIHb Yu ec1DC PREF q09bI ev lUX SS aT uF MO2C SG4oH FYb V Pr Rz k xG QW N5iT Bb NT G Kw Q ok6j+H6/zP nJ KU Sx W9ix+UNR dUh JB RW Vp mC95/5 3ij8HUWFpYXRy6TDkD INpMgNik3zYG383eCDHZKra on 03/06/2024  \nWhat the X? Understanding changes in buprenorphine prescribing regulation  \nChandra Speight, PhD, RN, NP-C, CNE1  \nABSTRACT  \nOpioid use disorder remains an epidemic in the United States. Buprenorphine is a Food and Drug Administration– approved medication for opioid use disorder that is associated with decreased opioid-related mortality and morbidity. Until recently, providers had to have a specialized wavier, a Drug Enforcement Agency (DEA) X, to prescribe buprenorphine for opioid use disorder. The 2023 Consolidated Appropriations Act, signed into law by President Biden, removed X waiver requirements and implements new training requirements for all new and renewing DEA registrants. This brief report outlines the history of buprenorphine prescribing regulation, reviews the recent regulatory changes and their implications for nurse practitioner buprenorphine prescribing, and concludes by considering the importance of promoting buprenorphine access.  \nKeywords: health care access; health policy; medications for opioid use disorder; opioid use disorder.  \nJournal of the American Association of Nurse Practitioners 36 (2024) 147–150, © 2023 American Association of Nurse Practitioners DOI\\# 10.1097/JXX.0000000000000942  \nBuprenorphine is an evidence-based opioid use disorder (OUD) treatment that is underused in the United States (U.S.) (Andrilla et al., 2019; Hirchak et al., 2022; Jones et al., 2018) . Until January 2023, providers needed a Drug Enforcement Agency (DEA) X wavier to prescribe buprenorphine for OUD (Substance Abuse and Mental Health Services Administration [SAMHSA], 2023b) . The 2023 Consolidated Appropriations Act, signed into law by President Biden, eliminated the DEA X waiver and mandated the DEA to implement new training requirements for all registrants by June 2023 (Consolidated Appropriations Act, 2022) . This brief report summarizes the history of buprenorphine prescribing regulation, describes the recent regulatory changes and their implications for nurse practitioners (NPs), and reviews the importance of promoting access to buprenorphine therapy.  \nBuprenorphine regulation history Buprenorphine, a partial opioid agonist with high affinityat the mu receptor, was initially developed as analgesic alternative (Chen et al., 2014) . Studies suggested buprenorphine would be effective in treating OUD; however, medication misuse was a concern because buprenorphine can be administered intravenously to achieve a  \n1Department of Advanced Nursing Practice and Education, College of Nursing, East Carolina University, Greenville, North Carolina Correspondence: Dr. Chandra Speight, PhD, RN, NP-C, CNE, E-mail:  \n[speightc20@ecu.edu or chandrasp8@gmail.com. Phone: 252-744-6433](speightc20@ecu.edu or chandrasp8@gmail.com. Phone: 252-744-6433). Fax: 252-744-6386. Cell phone: 252-341-9496.  \neuphoric effect (Sivils et al., 2022) . A buprenorphine– naloxone combination, which would precipitate withdrawal if injected, was developed to deter misuse. U.S. policy makers anticipated that the Food and Drug Administration (FDA) would approve buprenorphine and buprenorphine–naloxone combinations for OUD but felt the medication should be strictly regulated when prescribed for OUD (Fornili & Fogger, 2017) . In 2000, the U.S. federal government passed the Drug Addiction Treatment Act (DATA), which gave the DEA the authority to create the X waiver process to regulate buprenorphine prescribing. The legislation permitted nonaddiction medicine physicians who obtained an X waiver to prescribe Schedule III medications for OUD. Buprenorphine was and remains the only Schedule","cbCaigrJuIWWOHzP","https://ap.wps.com/l/cbCaigrJuIWWOHzP","pdf",183616,"English","# Abstract\n# Buprenorphine regulation history\n## DEA X waiver and DATA waivers\n## CARA and expanded waiver eligibility","[{\"question\":\"What did buprenorphine prescribing regulation require before January 2023?\",\"answer\":\"Before January 2023, providers generally needed a DEA X waiver to prescribe buprenorphine for opioid use disorder.\"},{\"question\":\"What changes were introduced by the 2023 Consolidated Appropriations Act?\",\"answer\":\"The 2023 Consolidated Appropriations Act removed the DEA X waiver requirement and implemented new training requirements for new and renewing DEA registrants.\"},{\"question\":\"Why does the report emphasize promoting buprenorphine access?\",\"answer\":\"The report concludes that supporting access to buprenorphine therapy is important for addressing opioid use disorder treatment needs.\"}]","What the X? Understanding changes in buprenorphine prescribing regulation | PDF",1789979259]