By Maeghan Gilmore
The landscape of medication‑assisted treatment (MAT) has shifted dramatically over the past few years. ABHW has long advocated for policies that expand access to evidence-based treatment for opioid use disorder (OUD), including supporting and advancing the Mainstream Addiction Treatment (MAT) Act, which eliminated the burdensome Data waiver (X Waiver) requirement in 2022. Following the passage of the MAT Act, and Congress’s expansion of training requirements for controlled‑substance prescribers, the U.S. Drug Enforcement Administration (DEA) has now finalized the regulatory updates needed to bring federal rules in line with these reforms.
The DEA’s new final rule, released on June 9, 2026, marks a turning point in how MAT is regulated for OUD. The rule finalizes portions of the 2020 interim rule that implemented the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018 (SUPPORT Act) and incorporates changes required by the Restoring Hope for Mental Health and Well‑Being Act of 2022, which passed in the Consolidated Appropriations Act of 2023. For years, clinicians had to navigate the extra layer of the DATA‑waiver system, the “X-Waiver,” with its specialized training requirements, patient caps, and administrative hurdles.
The X-Waiver has been replaced by a one-time training requirement for all prescribers of controlled substances. Instead of singling out clinicians who treat OUD, the new approach assumes that every prescriber should have some understanding of treating substance use disorders. If practitioners apply for or renew a DEA registration for Schedules II–V, they must complete this one-time training.
The rule also updates how pharmacies can support treatment. Previously, pharmacies were allowed to deliver certain controlled substances to clinicians for administration by injection or implantation, but the medication had to be used within 14 days. That window has now expanded to 45 days. The guardrails remain in place by requiring that the medication be tied to a specific patient, that it can’t be used to build office stock, and that both the pharmacy and the practitioner keep detailed records.
These changes represent a broader shift in federal policy. The barriers that once made it difficult for clinicians to prescribe buprenorphine have been dismantled. Pharmacies have clearer pathways to support treatments. And patients benefit from a system that is less about bureaucracy and more about access. It’s a recognition that MAT saves lives.
In the bigger picture, the final rule reinforces continued efforts to curb the overdose crisis and expand access to evidence‑based treatment while maintaining appropriate safeguards. As behavioral health plans continue to close treatment gaps and improve outcomes for members with OUD, this rule provides a clearer, more reliable framework to build on.
