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Special Circumstances for Providing Buprenorphine

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Learn about circumstances when physicians or other medical personnel can provide buprenorphine without a waiver.

Several federal laws and regulations permit physicians and other medical personal to administer medications approved by the Food and Drug Administration (FDA) for the treatment of opioid use disorders (OUD) under special circumstances.

Buprenorphine in Medical Emergencies

Under the Narcotic Addiction Treatment Act – 1974, all practitioners who use narcotic drugs for treating opiate addiction must obtain a separate registration under 21 U.S.C. Section 823(g)(1) or a DATA 2000 Waiver under 21 U.S.C. Section 823(g)(2). However, according to Drug Enforcement Administration (DEA), an exception to the registration requirement, known as the “three-day rule” (Title 21, Code of Federal Regulations, Part 1306.07(b)).

Practitioner requests to temporarily treat up to 275 patients in emergency situations

Regulation 42 CFR 8.655 states practitioners with a current waiver to prescribe up to 100 patients and who are not otherwise eligible to treat up to 275 patients under 42 CFR 8.610 may request a temporary increase to treat up to 275 patients in order to address emergency situations defined in 42 CFR 8.2 if the practitioner provides the required information and documentation.

Become a Buprenorphine Waivered Practitioner.

Become an Accredited and Certified Opioid Treatment Program.

Training and Resources

SAMHSA offers tools, training, and technical assistance to practitioners in the fields of mental health and substance use disorders. Find information on SAMHSA training and resources.

Last Updated

Last Updated: 09/16/2022