Buprenorphine Prescribing Requirements and Limitations

About this dataset:

Medications for opioid use disorder (MOUD), particularly agonist medications like buprenorphine and methadone, are one of the most effective tools for reducing opioid overdose deaths. Research shows that agonist medications can reduce mortality by up to 50% for people with opioid use disorder (OUD). Unlike methadone, which must be dispensed through a federally certified opioid treatment program, buprenorphine may be prescribed directly by practitioners in office-based settings.  

While the federal X-Waiver requirement for buprenorphine prescribing was eliminated in late 2022, state laws on buprenorphine prescribing for OUD remain, with some state regulatory schemes maintaining restrictive barriers to buprenorphine treatment access. These barriers include constraints on dosage, product formulation, and prescription length; and imposing high-threshold practices such as mandatory counseling and frequent drug testing. Conversely, state laws can be protective, such as by requiring the provision of the opioid overdose reversal drug naloxone and prohibiting punitive responses when patients decline counseling or other ancillary services.  

This dataset is longitudinal and displays key features of state-level statutes and regulations regarding buprenorphine prescribing for OUD outside of federally certified opioid treatment programs. The dataset includes laws across all 50 states and the District of Columbia in effect as of March 1, 2023, through September 1, 2024. The dataset does not include laws or policies that regulate buprenorphine prescribing exclusively within state Medicaid programs. The research protocol includes additional information on the scope of state laws captured by this dataset. 

These data were created with support from the Vital Strategies Overdose Prevention Program.