The 8-hour opioid or other substance use disorders training activities below (along with the other pathways) meet the Federal training requirement of the 2022 Medication Access and Training Expansion (MATE) Act. Completion will allow qualified physicians to apply for a Drug Enforcement Administration (DEA) initial registration or renewal registration on or after June 27, 2023. Physicians will be required to check a box on their online DEA registration affirming they completed the training requirement. The one-time training requirement affirmation will not be a part of future registration renewals.
Pathways to satisfy requirement:
- All practitioners that are board certified in addiction medicine or addiction psychiatry from the American Board of Medical Specialties, the American Board of Addiction Medicine, or the American Osteopathic Association.
- All practitioners that graduated in good standing from a medical, dental, physician assistant, or advanced practice nursing school in the United States within five years of June 27, 2023 and successfully completed a comprehensive curriculum that included at least eight hours of training on treating and managing patients with opioid or other substance use disorders including the appropriate use of all drugs approved by the FDA for the treatment of a substance use disorder.
- Engage in a total of eight hours of training on treatment and management of patients with opioid or other substance use disorders from an accredited group, including the APA. The eight hours does not need to occur in one session and past trainings on treatment and management of patients with opioid or other substance use disorders can count towards the requirement.
Past DATA-waived trainings count towards the DEA registrants eight-hour training requirement.
- Book-based Learning – Office-Based Buprenorphine Treatment of Opioid Use Disorder, Second Edition
- In-Depth Online Training via APA Learning Center
The Elimination of the Buprenorphine Waiver
In December 2022, The Mainstreaming Addiction Treatment (MAT) Act passed with the signing of the Consolidated Appropriations Act of 2023 eliminating the buprenorphine waiver (X waiver). In order to prescribe buprenorphine to patients, you must still get a DEA license registration number, but the previously used DATA-Waiver registration numbers are no longer needed for any prescriptions. The Act also eliminated limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine. Practitioners will be required to check a box on their online DEA registration form affirming that they have completed the new one-time training requirement.
HHS Releases Practice Guidelines for Administration of Buprenorphine for Treating Opioid Use Disorder (April 27, 2021)
In an effort to get evidenced-based treatment to more Americans with opioid use disorder, the Department of Health and Human Services (HHS) released new buprenorphine practice guidelines that among other things, remove a longtime requirement tied to training.
The Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder provides an exemption from certain certification requirements under 21 U.S.C. § 823(g)(2)(B)(i)-(ii) of the Controlled Substances Act (CSA). The Practice Guideline will be effective as soon as it is published in the federal register on April 28, 2021. As noted, eligible prescribers must submit a notice of intent to SAMHSA and receive a waiver before being able to treat patients under the Practice Guideline.
Specifically, the Practice Guidelines provide that:
- With respect to the prescription of certain medications that are covered under applicable provisions of the CSA, such as buprenorphine, practitioners, defined as physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives, who are licensed under state law, and who possesses a valid DEA registration, may be exempt from the certification requirements related to training, counseling and other ancillary services.
- Practitioners utilizing the exemption are limited to treating no more than 30 patients at any one time. Time spent practicing under the exemption will not qualify the practitioner for a higher patient limit.
- This exemption also allows practitioners to treat patients with buprenorphine without certifying as to their capacity to provide counseling and ancillary services.
- Under the exemption, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives are required to be supervised by, or work in collaboration with, a DEA registered physician if required by state law to work in collaboration with, or under the supervision of, a physician when prescribing medications for the treatment of opioid use disorder. This requirement does not apply to practitioners who are employees or contractors of a department or agency of the United States acting within the scope of such employment or contract.
- Practitioners who do not wish to practice under the exemption and its attendant 30 patient limit may seek a waiver per established protocols.
- The exemption applies only to the prescription of Schedule III, IV, and V drugs or combinations of such drugs, covered under the CSA, such as buprenorphine. It does not apply to the prescribing, dispensing, or the use of Schedule II medications such as methadone for the treatment of opioid use disorders.
- Before treating patients with buprenorphine for opioid use disorder, practitioners are required to obtain a waiver under the CSA by submitting a Notice of Intent to SAMHSA under established protocols. Learn more about becoming a waivered practitioner here..