Several developments in federal policy are likely to have significant impacts on access to treatment for substance use disorder (SUD) in 2023. These include (1) new legislation to allow all providers that are registered by the Drug Enforcement Administration (DEA) to prescribe buprenorphine, a key drug for the treatment of opioid addiction, (2) proposed rules to offer new operational flexibilities for methadone clinics, including greater flexibility to dispense take-home doses to patients when clinically appropriate, and (3) proposed rules to better align SUD treatment data confidentiality requirements with regulations for protected health information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA).