How to obtain a waiver to treat opioid use disorder with buprenorphine

Editor's note: As of June 27, 2023, federal guidelines no longer require physicians or advanced practice providers to obtain a waiver to treat patients with buprenorphine. All clinicians who prescribe controlled substances are instead required to complete eight hours of training in the prevention and treatment of substance use disorders.

Medication-assisted treatment (MAT) with buprenorphine for patients with opioid use disorder is an effective alternative to methadone that can be provided in family medicine practices. Preparing the office and the clinical team to provide this treatment requires several steps, including securing a waiver from the Substance Abuse and Mental Health Services Administration (SAMHSA). These are the five requirements:

1. Have an active and valid state medical license and, if required by your state, a state controlled substance license,

2. Register with the Drug Enforcement Administration to prescribe controlled substances,

3. Complete at least eight hours of MAT waiver training or certification by an appropriate organization (free online and in-person training options are available),

4. Complete the SAMHSA waiver notification form, and

5. Be capable of referring patients to counseling services.

In the first year after acquiring the waiver, physicians may provide buprenorphine treatment to 30 patients. Thereafter, physicians can use the waiver notification form to apply to increase their patient capacity to 100 patients in the second year and 275 patients in the third year.

Read the full FPM article: “Preparations for Treating Opioid Use Disorder in the Office.”