The National Association of Boards of Pharmacy® (NABP®) continues its call for the passage of the Mainstreaming Addiction Treatment Act to remove barriers that prevent those with opioid use disorder (OUD) from accessing vital, lifesaving addiction treatment. This bipartisan bill was introduced today by Representatives Paul Tonko (D-NY), Michael Turner (R-OH), Antonio Delgado (D-NY), Anthony Gonzalez (R-OH) and Senators Maggie Hassan (D-NH) and Lisa Murkowski (R-AK). The legislation ends outdated limits imposed through the so-called “X waiver” that have restricted health care providers from prescribing buprenorphine, a safe and proven treatment of OUD.
“Representative Paul Tonko has been a tireless leader in expanding access to addiction treatment and much needed medication addition treatment. We thank him, his staff, and the bipartisan congressional leaders who continue to bring this important legislation to the forefront,” says NABP President Timothy D. Fensky, RPh, DPh, FACA.
The X waiver was implemented as part of the Drug Addiction Treatment Act of 2000, and is required for providers who seek to treat opioid dependency outside of a formal opioid treatment program. The X waiver process necessitates the completion of additional training, puts a cap on the number of patients each provider can treat with medication-assisted treatment (MAT), and does not include pharmacists as eligible providers. Requiring that providers go through extra steps to be able to treat OUD patients with buprenorphine or methadone is senseless considering that they can prescribe these and other controlled substances for pain management without doing so.
Another by-product of the X waiver is the underutilization of pharmacists’ accessibility and expertise. There are over 80,000 pharmacy locations across the country, uniquely positioning pharmacists to expand access to this critical therapy. They could easily take on the role of prescribing MAT, particularly to address gaps in care. Pharmacists can help develop treatment plans, communicate with patients, coordinate care, and monitor adherence and improvement, along with prescribing and dispensing buprenorphine medications.
The MAT Act would place the decision of which health care providers can offer MAT at the state level, allowing each jurisdiction to address this issue in the way that works best for their residents. States across the country already have regulations in place that grant pharmacists authority to prescribe some drugs in specific situations, and they would likely consider allowing pharmacists to prescribe MAT if not for the X waiver and current federal restrictions.
More information about MAT and the role of pharmacists can be found on the NABP website.