Treatment of Opioid Use Disorder: Waiver Qualifying - ACOG - Kansas City, MO - Sunday, July 15, 2018

Overview of Legislation

Physicians

The Drug Abuse Treatment Act of 2000 (DATA 2000) specifies training is necessary for physicians to obtain a waiver to engage in office‐based treatment of opioid use disorders using drugs approved by the FDA on Schedules III, IV, and V. This course addresses those requirements using a curriculum approved by CSAT/SAMHSA and ASAM, who is one of the national organizations named in the DATA 2000 legislation as eligible to prepare and administer these courses.

Nurse Practitioners & Physician Assistants

On July 22, 2016, President Obama signed the Comprehensive Addiction and Recovery Act (CARA) into law. CARA authorizes qualified NPs and PAs to become waivered to prescribe buprenorphine in office-based settings for patients with Opioid Use Disorder (OUD) for a five-year period expiring in October 2021.    

To qualify, NPs and PAs must: 

• Be licensed under state law to prescribe schedule III, IV, or V medications for pain  
• Complete not less than 24 hours of appropriate education through a qualified provider
• Through other training or experience, demonstrate the ability to treat and manage OUD  
• If required by state law, be supervised or work in collaboration with a qualifying physician to prescribe medications for the treatment of OUD

HHS' announcement on November 16, 2016, enables NPs and PAs to immediately begin taking the 24 hours of required training. For the full HHS announcement, click here.

NPs and PAs can begin the training immediately by taking the 8-hour buprenorphine course ASAM currently offers or that other stakeholders offer (see below for more information). The remaining 16 hours will have to be completed with one training provider. ASAM is developing multiple 16-hour training course options and formats, including collaborations with:

• 24-Hour Buprenorphine Curriculum Collaborative with the American Association of Nurse Practitioners (AANP) and the American Academy of Physician Assistants (AAPA)
• Clinical Tools, Inc
• Provider's Clinical Support System for Medication-Assisted Treatment (PCSS-MAT)

Apply

• Fill out the Waiver Notification Form on SAMHSA’s website.
• Submit copies of your training certificate(s) to SAMHSA by email: infobuprenorphine@samhsa.hhs.gov or fax: 301.576.5237.

SAMHSA reviews waiver applications within 45 business days of receipt. If approved, you will receive a letter via email that confirms your waiver and includes your prescribing identification number.

Waiver applications are forwarded to the DEA. DEA regulations require your prescribing identification number to be included on all buprenorphine prescriptions for opioid dependency treatment, along with your regular DEA number.

If you have not received confirmation of receipt of your application, or if it has been more than 45 business days since submitting it, contact CSAT by email: infobuprenorphine@samhsa.hhs.gov or call 866.287.2728.

Please ensure that your state regulations allow you to prescribe buprenorphine and other medications to treat OUD before you apply for the waiver.  Some states may have overriding state legislation that will prevent NPs and PAs from prescribing these medications even if Federal law allows it.

Apply

• Fill out the Waiver Notification Form on SAMHSA’s website.
• Submit copies of your training certificate(s) to SAMHSA by email: infobuprenorphine@samhsa.hhs.gov or fax: 301.576.5237.

SAMHSA reviews waiver applications within 45 business days of receipt. If approved, you will receive a letter via email that confirms your waiver and includes your prescribing identification number.

Waiver applications are forwarded to the DEA. DEA regulations require your prescribing identification number to be included on all buprenorphine prescriptions for opioid dependency treatment, along with your regular DEA number.

If you have not received confirmation of receipt of your application, or if it has been more than 45 business days since submitting it, contact CSAT by email: infobuprenorphine@samhsa.hhs.gov or call 866.287.2728.

Qualify 

To qualify for a waiver to treat patients with Opioid Use Disorder, NPs and PAs must: 

• Be licensed under state law to prescribe schedule III, IV, or V medications for pain
• Complete no less than 24 hours of appropriate education through a qualified provider
• Through other training or experience, demonstrate the ability to treat and manage OUD
• If required by state law, supervision or working in collaboration with a qualifying physician to prescribe medications for the treatment of OUD may be required.

CME Information and Disclosure Listing

Date of Release: July 2015
Approved Through: July 2018

The American Society of Addiction Medicine (ASAM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Society of Addiction Medicine designates this enduring material for a maximum of 4 AMA PRA Category 1 Credits™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

The American Society of Addiction Medicine designates this live activity for a maximum of 4 AMA PRA Category 1 Credits™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

The combined online enduring material and live activity will provide the required 8 hours needed to obtain the waiver to prescribe buprenorphine in office-based treatment of opioid use disorders.

This course has been designated as an approved CME Activity by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Maintenance of Certification (MOC) Program can apply a maximum of 8 AMA PRA Category 1 Credit(s)™ to the CME requirement for Part II: Lifelong Learning and Self-Assessment.

In accordance with the disclosure policies of ASAM and the ACCME, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all educational activities. These policies include resolving all conflicts of interest between the CME Committee, Planning Committee and faculty, and commercial interests that might otherwise compromise the goal and educational integrity of this activity. All CME Committee, Planning Committee and faculty participating in the activity have disclosed all relevant financial relationships with commercial interests. The CME Committee has reviewed these disclosures and determined that the planning committee and faculty relationships are not inappropriate in the content of their respective presentations and are not inconsistent with the educational goals and integrity of the activity.

ASAM CME Committee

ASAM Buprenorphine Program Planning Committee

ASAM Buprenorphine Course Faculty

ASAM CME Committee Reviewers

Learners will be able to:

1. Apply for a waiver to prescribe buprenorphine to their patients with opioid use disorders
2. Identify and assess patients who are appropriate for treatment with medications
3. Have specific knowledge concerning the use of medications to manage patients with addiction involving opioid use
4. Discuss the psychiatric and medical co-morbidities associated with opioid addiction

1. Locate the box on the right that says “Module 1" and click “View Web Content On-Demand"
2. Locate the box on the right that says “Certificate code" and enter the code given upon completion of Module 1 Part 1
3. Continue to Module 1 Part 2 and Module 1 Part 3
4. Once you have completed the entire module, locate the box called “Module 1 Quiz" and choose “Take Quiz"
5. After you have completed Module 1 Quiz, continue to modules 2 and 3
6. You will be required to pass all 3 Module Quizzes with a grade of 70% or higher
7. Upon completion of both the 4 online hours and 4 live hours of the course, you will be able to claim CME Credit through the ASAM e-Learning Center

1. Physicians, Nurse Practitioners, and Physician Assistants who wish to obtain a waiver to prescribe buprenorphine in office based treatment of opioid use disorders.
2. Clinicians and health care team members working with physicians who prescribe buprenorphine in office based treatment of opioid use disorders.

The ASAM Treatment of Opioid Use Disorder Course has been made available in part by an unrestricted educational grant from Indivior Inc.