What is an X Waiver?
An “X waiver” refers to the Drug Addiction Treatment Act (DATA 2000) “waiver” legislation that authorized the outpatient use of buprenorphine for the treatment of opioid use disorder.
Why Get One?
Any clinician can administer buprenorphine to a patient with opioid withdrawal symptoms in the hospital. However, in order to write prescriptions for buprenorphine clinicians must have an X Waiver. Having a prescription for buprenorphine to leave the hospital with can be a critical linkage step for a patient to successfully continue in their recovery.
Who Can Become X Waivered?
Physicians, Nurse Practitioners (NPs), Physician Assistants (PAs), Clinical Nurse Specialists (CNSs), Certified Registered Nurse Anesthetist (CRNAs), and Certified Nurse-Midwifes (CNMs) can pursue this free online training. See here for more details.
How Can I Get X Waivered?
Fill out the Buprenorphine Waiver Notification of Intent (NOI) form through Substance Abuse and Mental Health Services Administration (SAMHSA). You will need to upload your training certificate from step 1.
These waiver applications are forwarded to the DEA, which assigns the physician a special designation. DEA regulations require this prefix “X”number to be included on all buprenorphine prescriptions for opioid use disorder treatment, and precede the clinician’s regular DEA registration number.
It may take a few days for your application to be verified in the SAMHSA website. You can check your status here.
EPrescribing Narcotic Addiction Medication w/ the Narcotic Addiction DEA number or X-waiver.
Suboxone (and all buprenorphine-containing drugs) will need additional steps completed to be e-prescribed. When attempting to e-prescribe these medications the provider will receive an inline order validation message. The message prompts for NADEAN: This terminology is referring to the provider’s X waiver number. The X waiver number is your usual DEA number preceded with the letter X (if you have completed your X waiver training). Preface with NADEAN: to have the number passed to the pharmacy.
To complete the e-prescribe process-