Buprenorphine Dispensing after Elimination of the Waiver Requirement

This letter assesses the impact of the U.S. government's 2023 removal of the DEA waiver requirement for prescribing buprenorphine, a key medication for opioid use disorder (OUD). Using national prescription data, the authors observed a sharp increase in the number of buprenorphine prescribers post-policy change, with over 53,000 active prescribers by December 2023. However, this expansion did not yield a proportional rise in total patients receiving buprenorphine or in new treatment initiations. While new initiations did increase modestly in January 2023, the rate plateaued. The authors conclude that although the policy reduced barriers for clinicians, it alone was insufficient to meaningfully expand buprenorphine use. They underscore the need for broader systems-level interventions to close persistent gaps in OUD treatment access.

This letter assesses the impact of the U.S. government's 2023 removal of the DEA waiver requirement for prescribing buprenorphine, a key medication for opioid use disorder (OUD). Using national prescription data, the authors observed a sharp increase in the number of buprenorphine prescribers post-policy change, with over 53,000 active prescribers by December 2023. However, this expansion did not yield a proportional rise in total patients receiving buprenorphine or in new treatment initiations. While new initiations did increase modestly in January 2023, the rate plateaued. The authors conclude that although the policy reduced barriers for clinicians, it alone was insufficient to meaningfully expand buprenorphine use. They underscore the need for broader systems-level interventions to close persistent gaps in OUD treatment access.