Changes in U.S. Clinician Waivers to Prescribe Buprenorphine Management for Opioid Use Disorder During the COVID-19 Pandemic and After Relaxation of Training Requirements


Joanne Spetz, Laurie Hailer, Caryl Gay, Matthew Tierney, Laura Schmidt, Bethany Phoenix, and Susan Chapman

May 12, 2022

The COVID-19 pandemic worsened the opioid overdose crisis. Buprenorphine management for opioid use disorder (OUD) reduces overdose risk and can be offered in office-based settings or via telehealth. Federal regulations require that clinicians complete training and obtain a waiver from the Drug Enforcement Administration (DEA) to prescribe buprenorphine. To increase buprenorphine access during the COVID-19 pandemic, federal and state regulations were relaxed to allow greater use of telehealth. Additionally, starting in April 2021, new guidelines allow clinicians to submit a Notice of Intent application to treat 30 or fewer patients without training; training is required for larger patient panels. This study examines the numbers of clinicians with waivers before and during the pandemic using national data.