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).

These new and proposed flexibilities are critically important, given the ongoing and worsening substance use disorder epidemic in the United States, which has been further exacerbated by the COVID-19 pandemic. The most recent available data analyses from the Centers for Disease Control and Prevention (CDC) show that an estimated 107,375 people in the United States died from a drug overdose in the 12-month period ending in January 2022. Many of these changes complement the strategies that articulated in the 2022 CMS Behavioral Health Strategy, as the Biden administration continues to seek ways to enhance access to high quality mental health and substance use disorder services.