All about the X waiver

Buprenorphine Basics

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?

Step 1:

Complete buprenorphine training. 8 hour for physicians, 24 hours for nurses, and 24 hours for PAs.

Step 2:

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

Are you a Penn provider, looking to e-prescribe buprenorphine?