Pass the MAT Act

November 2022

The Mainstreaming Addiction Treatment Act prevents overdoses, increases access to treatment, reduces stigma

November 29, 2022 

The Honorable Nancy Pelosi 
U.S. House of Representatives 1236
Longworth House Office Building
Washington, DC 20515 

The Honorable Charles Schumer
U.S. Senate 322
Hart Senate Office Building
Washington, DC 20510 

The Honorable Kevin McCarthy
U.S. House of Representatives
2468 Rayburn House Office Building
Washington, DC 20515 

The Honorable Mitch McConnell
U.S. Senate
317 Russell Senate Office Building
Washington, DC 20510 

RE: The Mainstreaming Addiction Treatment Act (“MAT Act,” S. 445 / H.R. 1384)

Dear Speaker Pelosi, Majority Leader Schumer, Leader McConnell, and Leader McCarthy:

The nearly 200 undersigned organizations urge you to pass the bipartisan Mainstreaming Addiction Treatment Act (“MAT Act”, S. 445, H.R. 1384) by the end of the session. In the midst of a deadly and accelerating overdose crisis, the MAT Act is a common-sense solution that will prevent overdoses, increase access to treatment, and reduce stigma.

If we fail to act, a million more families will bury parents and children due to overdoses over the next decade.

The MAT Act has strong bipartisan support. The House passed the MAT Act by an overwhelming bipartisan majority as part of the Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666). With more than 260 Democratic, Republican, and Independent co-sponsors – including the Chairs of the Democratic Caucus and the Republican Conference and Senators from all parties, the MAT Act is among the most broadly supported pieces of overdose prevention legislation introduced in Congress this session. Both President Biden’s and President Trump’s former Directors of the Office of National Drug Control Policy have called for Congress to pass the MAT Act.i They join the bipartisan U.S. Commission on Combating Synthetic Opioid Trafficking in urging Congress to pass the policy.ii

Together, our organizations represent and serve millions on the front lines of the overdose crisis. Our organizations include people and families personally affected by the overdose crisis, law enforcement professionals and first responders, health care and behavioral health providers, Veterans, faith-based leaders, recovery and harm reduction specialists, social justice advocates, payers, and public health experts. We have come together to ask you to act on the overdose crisis now. By passing the MAT Act, you have the opportunity to increase access to a treatment that can open the doors of healing and recovery to millions.

The MAT Act removes outdated barriers that prevent health care providers from prescribing a safe and effective treatment for opioid use disorder, known as buprenorphine. Buprenorphine and medications like it cut the risk of overdose death in half and reduce fentanyl use by preventing painful withdrawal symptoms and stemming opioid cravings. The medication has been FDA-approved for opioid use disorder for twenty years and is available in generic. Buprenorphine is considered a gold standard of care for opioid use disorder because it saves lives and helps individuals secure long-term recovery.iii

But due to outdated federal rules that prevent health care providers from prescribing buprenorphine (known as the “X-waiver”), only about 1 in 10 people with opioid use disorder receive medications for the condition.iv Fully 40% of U.S. counties lack a single health care provider who can prescribe buprenorphine for opioid use disorder.v This lack of access to buprenorphine is devastating our families and causing tens of thousands of preventable overdose deaths each

The MAT Act will help integrate substance use treatment into primary care practices, emergency departments, behavioral health care practices, and other health care settings. The bill will allow all health care providers with a standard controlled medication license to prescribe buprenorphine for opioid use disorder, subject to state licensure requirements. The bill will also expand access to training by launching a national education campaign on best practices for treating substance use disorder. The MAT Act will equip states and local governments with a key tool to address the unique treatment needs of their communities.

We have witnessed the profound suffering that overdoses have wrought on our families and communities. More than 108,000 loved ones now lose their lives to an overdose in a year, with 2021 marking the deadliest year yet. Two-thirds of those deaths involved synthetic opioids, including fentanyl.vii If we fail to act, a million more families will bury parents and children due to overdoses over the next decade.viii

We look forward to working together to help ensure that treatment that can prevent overdoses and support long-term recovery from opioid use disorder is accessible to everyone in need. We urge you to pass the MAT Act by the end of the session to save lives and to extend the hope of healing to communities across the country. With overdose deaths rising at alarming rates, the time to destigmatize and expand access to safe and effective treatment is now.

Thank you for your consideration. Please reach out to Erin Schanning at End Substance Use Disorder (—— for more information.

cc: The Honorable Patty Murray
The Honorable Richard Burr
The Honorable Frank Pallone, Jr.
The Honorable Cathy McMorris Rodgers


AIDS United
American Academy of Emergency Medicine (AAEM)
American Academy of PAs
American Academy of Pediatrics
American Academy of Physical Medicine and Rehabilitation (AAPM&R)
American Association of Nurse Practitioners
American Association of Psychiatric Pharmacists (AAPP)
American College of Emergency Physicians
American College of Medical Toxicology
American Foundation for Suicide Prevention
American Jail Association
American Medical Association
American Muslim Health Professionals
American Pharmacists Association (APhA)
American Society of Health-System Pharmacists (ASHP)
Association for Ambulatory Behavioral Healthcare (AABH)
Association for Behavioral Health and Wellness
Association of American Medical Colleges
Association of Maternal & Child Health Programs
Association of Prosecuting Attorneys
Big Cities Health Coalition
Blue Future
Build Back Better USA
Coalition on Human Needs
College of Healthcare Information Management Executives (CHIME)
Community Catalyst
Dooner Social Ventures
Drug Policy Alliance
End Substance Use Disorder
Fair and Just Prosecution
Friends Committee on National Legislation
Global Alliance for Behavioral Health and Social Justice
Health in Justice Action Lab
Healthcare Leadership Council
International Association of Fire Chiefs
International Society for Psychiatric Mental Health Nurses
InterReligious Task Force on Central America and Colombia
Law Enforcement Action Partnership
Magellan Health
Mental Health America
National Advocacy Center of the Sisters of the Good Shepherd
National Alliance of State and Territorial AIDS Directors (NASTAD)
National Association for Rural Mental Health
National Association of Attorneys General
National Association of Boards of Pharmacy
National Association of Counties (NACo)
National Association of County Behavioral Health and Developmental Disability Directors
National Association of Pediatric Nurse Practitioners
National Commission on Correctional Health Care (NCCHC)
National Council for Mental Wellbeing
National District Attorneys Association (NDAA)
National Health Care for the Homeless Council
National Health Law Program
National League for Nursing
National Prevention Science Coalition
National Rural Health Association
National Safety Council
National Sheriffs’ Association
National Viral Hepatitis Roundtable (NVHR)
NETWORK Lobby for Catholic Social Justice
New Directions Behavioral Health
Next Harm Reduction aka NEXT Distro
Organizational Wellness Learning Systems
Overdose Crisis Response Fund
Overdose Prevention Initiative at the Global Health Advocacy Incubator
Partnership to End Addiction
PAs in Virtual Medicine and Telemedicine
People’s Action
Police, Treatment, and Community Collaborative (PTACC)
SAFE Project
Society of Behavioral Medicine
Society of Hospital Medicine
Society of Pain and Palliative Care Pharmacists
The Hepatitis C Mentor and Support Group (HCMSG)
The Kennedy Forum
The Pew Charitable Trusts
The Sentencing Project
The United Methodist Church – General Board of Church and Society
Treatment Action Group
Treatment Advocacy Center
Veterans for Common Sense
Vital Strategies
Wounded Warrior Project
Young People in Recovery

AIDS Alabama (Alabama)
Hometown Action (Alabama)
Southwest Recovery Alliance (Arizona)
CA Bridge (California)
Chop Wood, Carry Water Progressive Action Newsletter (California)
Father Joe’s Villages (California)
Monterey County Prescribe Safe Initiative (California)
Northridge Indivisible (California)
Ascending To Health Respite Care (Colorado)
Colorado Coalition for the Homeless (Colorado)
Peak Vista Community Health Centers (Colorado)
Florida Harm Reduction Collective (Florida)
Hawai’i Health & Harm Reduction Center (Hawai’i)
Hep Free Hawai’i (Hawai’i)
United Vision for Idaho (Idaho)
AIDS Foundation Chicago (Illinois)
Center for Housing & Health (Illinois)
Communities United (Illinois)
Illinois Harm Reduction & Recovery Coalition (Illinois)
Live4Lali (Illinois)
The Night Ministry (Illinois)
Hoosier Action (Indiana)
Iowa Citizens for Community Improvement (Iowa)
Iowa Primary Care Association (Iowa)
VOCAL-KY (Kentucky)
Ochsner Health (Louisiana)
Maine People’s Alliance (Maine)
Health Care for the Homeless-Baltimore (Maryland)
Progressive Maryland (Maryland)
Duffy Health Center (Massachusetts)
Michigan State Medical Society (Michigan)
Wellness Services Inc. (Michigan)
Hennepin County, Minnesota (Minnesota)
Rights and Democracy (New Hampshire and Vermont)
End Overdose Together (New Jersey)
New Jersey Association of Mental Health and Addiction Agencies, Inc. (New Jersey)
New Jersey Harm Reduction Coalition (New Jersey)
New Jersey Organizing Project (New Jersey)
Newark Homeless Outreach (New Jersey)
Northern MAT Center of Excellence (New Jersey)
Sea Change RCO (New Jersey)
Albuquerque Health Care for the Homeless, Inc. (New Mexico)
Amador Health Center (New Mexico)
Care For the Homeless (New York)
Citizen Action of New York (New York)
Columbia University Mailman School of Public Health (New York)
Southern Tier AIDS Program/Southern Tier Care Coordination (New York)
Truth Pharm Inc. (New York)
VOCAL-NY (New York)
Benevolence Farm (North Carolina)
Fruit of Labor Action Research & Technical Assistance, LLC (North Carolina)
Guilford County Solution to the Opioid Problem (GCSTOP) (North Carolina)
Halifax County Health Department (North Carolina)
NC Public Health Association (North Carolina)
North Carolina AIDS Action Network (North Carolina)
North Carolina Harm Reduction Coalition (North Carolina)
Tia Hart Community Recovery Program (North Carolina)
Brave Technology Co-Op (Ohio)
Caracole (Ohio)
Cincinnati Health Network (Ohio)
Harm Reduction Ohio (Ohio)
Nelsonville Voices (Ohio)
Ohio Association of Community Health Centers (OACHC) (Ohio)
Ohio Council of Churches (Ohio)
OhioCAN (Ohio)
River Valley Organizing (Ohio)
Showing Up for Racial Justice Ohio (Ohio)
Central City Concern (Oregon)
HIV Alliance (Oregon)
Oregonizers (Oregon)
North-Star Care (Pennsylvania)
Pennsylvania Harm Reduction Network (Pennsylvania)
Reclaim Philadelphia (Pennsylvania)
University of Pittsburgh Medical Center (UPMC) (Pennsylvania)
Project Weber/RENEW (Rhode Island)
Clear Bell Solutions (South Carolina)
United Way of West Tennessee (Tennessee)
United Ways of Tennessee (Tennessee)
Meadows Mental Health Policy Institute (Texas)
Texas Center for Justice & Equity (Texas)
Texas Harm Reduction Alliance (Texas)
Congregation of Our Lady of Charity of the Good Shepherd, U.S. Provinces (U.S. Provinces)
Association for Utah Community Health (Utah)
Virginia Rural Health Association (Virginia)
Blue Mountain Heart to Heart (Washington)
Country Doctor Community Health Centers (Washington)
Family Health Centers (Washington)
Hassanah Consulting (Washington)
HealthPoint (Washington)
Neighborcare Health (Washington)
Northwest Health Law Advocates (Washington)
Public Health – Seattle & King County (Washington)
Spokane Police Department (Washington)
Summit Pacific Medical Center (Washington)
WA Academy of Family Physicians (Washington)
WA Association of Community Health (Washington)
WA Society of Addiction Medicine (Washington)
Washington Community Action Network (Washington)
Washington State Medical Association (WSMA) (Washington)
Yakima Neighborhood Health Services (Washington)
WV Citizen Action Group (West Virginia)
Citizen Action of Wisconsin (Wisconsin)

i Regina LaBelle, After a brutal year of overdose deaths, the US needs urgent, coordinated action, The Hill (Jan. 3, 2022); Jim Carroll, To save lives from addiction, Congress should pass the MAT Act, Washington Examiner (May 16, 2022). 

ii U.S. Commission on Combating Synthetic Opioid Trafficking, Final Report, at p. 49-50 (Feb. 8, 2022). 

iii See Nat’l Acad. of Sciences, Engineering, and Medicine, Consensus Study Report: Medications for Opioid Use Disorder Save Lives, Nat’l Acad. Press (2019); U.S. Commission on Combating Synthetic Opioid Trafficking, Final Report, at p. 30-31. 

iv Substance Abuse and Mental Health Svcs. Admin., Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health, at p. 41 (Oct. 2021). 

v U.S. Dep’t Health and Human Svcs., Office of Inspector General, Geographic Disparities Affect Access to Buprenorphine Services for Opioid Use Disorder, at Report in Brief and p. 10 (Jan. 2020). 

vi See Kevin Fiscella, MD, MPH, Sarah E. Wakeman, MD, Leo Beletsky, JD, MPH, Buprenorphine Deregulation and Mainstreaming Treatment for Opioid Use Disorder: X the X Waiver, 76(3) JAMA Psychiatry 229-30 (2018). 

vii Centers for Disease Control and Prevention, 12 Month-Ending Provisional Number of Drug Overdose Deaths (Aug. 2022). 

viii Meryl Kornfield, U.S. surpasses record 100,000 overdose deaths in 2021, The Washington Post (May 11, 2022).