Background: DATA 2000 X-waiver training has existed for over 20 years, however, less than 10% of eligible practitioners have been waivered. The purpose of this study was to understand practitioners’ perceptions of X-waiver training and to assess the feasibility of virtual X-waiver training.

Methods: Three separate virtual X-waiver training courses were provided from December 2020 through September 2021. Pre- and post-training surveys were developed to understand practitioners’ attitudes toward patients with opioid use disorder (OUD) and to evaluate the effect of the training. All participants were invited to complete surveys anonymously via Qualtrics.

Results: Among 168 participants, 140 and 133 completed pre- and post-training surveys, respectively. Analysis of the pre-training survey data showed that 80% of practitioners were willing to treat patients with OUD. Post-training responses documented significant improvements in diagnosing OUD and recognizing opioid withdrawal symptoms. Similarly, post-training results showed 96% of respondents noted improved confidence in their capacity to prescribe buprenorphine. Approximately 69% of respondents in the pre-training survey were not aware of local community resources to refer patients for substance use treatment; this was reduced to 34% in post-training responses. Postsurvey qualitative data revealed that participants thought the virtual training was efficient, however, suggested more in-person interaction and lecture-based discussion. In addition, respondents continued to report persistent barriers to implementation of buprenorphine prescribing.

Conclusion: This study demonstrated the feasibility of delivering X-waiver training virtually. In addition, X-waiver training improved practitioners’ knowledge and comfort in identifying and managing OUD although persistent barriers to buprenorphine prescribing remain despite training.