ASHEVILLE, N.C. — Dr. Blake Fagan hopped in the car and headed to a once-in-a-lifetime opportunity at the White House. He was one of two doctors from North Carolina invited to celebrate the passing of the Mainstream Addiction Treatment act, also known as the MAT Act. 


What You Need To Know

  • A measure was passed aiming to improve accessibility to medication-assisted treatment for people struggling with Opioid Use Disorder

  • The X-Waiver process restricted accessibility to treatment, especially in rural areas. The MAT Act removes the requirement for an X-Waiver for any prescriber to treat patients with buprenorphine

  • Blake Fagan was one of two North Carolina doctors invited to the White House to celebrate the MAT Act

“I thought this was exciting, this was something that I’ve been working on for almost a decade,” Fagan said. “I probably will never be invited to the White House again, so I said yes and made the arrangements to get up to Washington.”

Fagan directs the opioid treatment services at the Mountain Area Health Education Center (MAHEC) Family Health Centers. 

“As a physician you had to do eight hours of training and get this thing called an X-Waiver,” Fagan said.

An X-Waiver was required for any provider prescribing buprenorphine — used to treat Opioid Use Disorder. 

Results from the 2020 National Survey on Drug Use and Health stated that among the 2.5 million people ages 12 and older with a past year opioid use disorder, 11.2% of those people received medication-assisted treatment for it in that year. 

The X-Waiver process restricted accessibility to treatment, especially in rural areas. The MAT Act removes the requirement for an X-Waiver for any prescriber to treat patients with buprenorphine. 

The American Institute for Research found that rural and urban counties have similar needs for treatment, but disparities in access. It found 65% of high-need counties had low-to-no buprenorphine prescribing capacity.

“This is breaking down a lot of barriers,” Fagan said. “So we are going from having in the whole United States, about 130,000 providers, to now 1.8 million providers in the United States can write this medicine.”

One opioid overdose death changed the course of Fagan's career. This was a patient he worked closely with.

“When this patient died from an overdose, it was devastating to me,” Fagan said. “I had a 10-year history with this patient, and I delivered her two kids.”

He believes this measure is something the country has needed for a long time.

“If we had passed something like the MAT Act before, years or decades ago, I think that we would have less opioid overdose deaths in the United States, just to be frank,” Fagan said.