24-Hour Waiver Training: AAPA

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This package contains 24 hours of required education for NP/PA/CRNA/CNM/CNS to qualify for a waiver to prescribe buprenorphine in an office-based setting. This curriculum covers all medications and treatments for opioid use disorder, in addition to other topics including medical maintenance and withdrawal, FDA-approved medications, initial and periodic patient assessment, and counseling and recovery support.

  • Part 1: The ASAM Treatment of Opioid Use Disorder Course 8-Hour Online

    Contains 8 Component(s), Includes Credits

    This course covers all approved medications to treat opioid use disorder and provides the 8 hours of education needed to receive a waiver to prescribe buprenorphine in an office-based setting.

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    Welcome to The ASAM Treatment of Opioid Use Disorder Course. This course provides 8 hours of education needed to receive a waiver to prescribe buprenorphine in an office-based setting. More information on waiver requirements can be found on the SAMHSA website. This course was updated in August 2018.

    To begin the online course, please log-in to your left and locate the box that says, "Module 1" in the "Contents" tab. If you do not know your password, or you have forgotten it, select "Forgot Password" and you will be emailed a link to reset your password.

    Instructions for completing the course can be found in the "Course Instructions" tab. After completing the online modules, corresponding quizzes, and applicable evaluations, return here to claim CME for the course. 

    If you have any questions, please contact education@ASAM.org.

    Daniel P. Alford

    MD, MPH, FACP, DFASAM

    Dr. Daniel P. Alford is an Associate Professor of Medicine, Assistant Dean of CME and Director of the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program at Boston University School of Medicine. He is a diplomate in Addiction Medicine by the American Board of Addiction Medicine (ABAM).

    He is director of the Clinical Addiction Research and Education Unit medical director of the Office-Based Opioid Treatment (OBOT) program and of the Massachusetts Screening, Brief Intervention, Referral to Treatment Training and Technical Assistance (MASBIRT TTA) program and former program director for the Addiction Medicine Fellowship program at Boston Medical Center (BMC). Since 2001 he has served as the course director of the Chief Resident Immersion Training (CRIT) Program in Addiction Medicine: Improving Clinical and Teaching Skills for Generalists funded by NIDA. He is president of the Association for Medical Education and Research in Substance Abuse (AMERSA). In 2011, he was recognized as a Champion of Change by the White House. In 2014 he received the Health Education Award from the American Medical Association.

    R. Corey Waller

    MD, MS, DFASAM

    R. Corey Waller, MD, MS, FACEP, DFASAM, is an addiction, pain and emergency medicine specialist. Dr. Waller earned his bachelor's degree in biology and his master's degree in neuromolecular biology at Southwest Texas State University in San Marcos, Texas. He earned his medical degree at University of Texas Medical School in San Antonio. Dr. Waller completed his emergency medicine residency at Thomas Jefferson University in Philadelphia. He is board certified and fellowship trained in addiction medicine.

    Debra Newman

    PA-C, MPAS, MPH

    Debra R. Newman, PA-C, MPAS, MPH currently serves as treatment provider for First Judicial District Court, Adult Drug Court for Santa Fe and Rio Arriba Counties, New Mexico. She also serves as Treatment Provider for Magistrate/DWI Court for Santa Fe County, New Mexico. Debra has worked in residential treatment as well as out-patient adult psychiatry and addiction medicine. Her passion for addiction medicine began with her association with Project ECHO in 2008. While employed at an FQHC in northern NM in a region historically plagued with the highest per capita heroin death rate in the nation, Debra worked under an addiction medicine psychiatrist and several family practice physicians waivered to prescribe buprenorphine. For over four years, she managed over 200 buprenorphine patients monthly, as the only full-time provider for these patients, while also carrying a caseload of HCV and chronic pain patients. Debra is the 2018 recipient of the PA Foundation NIDA mentored outreach award in SUD treatment dissemination. Also in 2018, she received an award through NIDA and the PA Foundation to present a symposium to PA students on SUD at the annual AAPA conference in Denver, CO. Debra has received recognition by Project ECHO for Bringing Expertise in Chronic Pain and Headache Management to Rural and Underserved New Mexicans. She currently works with several different community organizations in an effort to stem the tide of rising overdose death rates throughout northern New Mexico, as New Mexico still ranks #1 in deaths west of the Mississippi. She serves as the President of the Society of Physician Assistants in Addiction Medicine (SPAAM). 

    Marian Currens

    Associate Director, University of Maryland Medical Center Midtown Campus

    Marian Currens, CRNP is located in Baltimore, MD.

    Learning Objectives:

    1. Assess patients for the full spectrum of harmful opioid use including misuse and use disorder
    2. Describe the current epidemiologic trends in opioid misuse including overdose and use disorders
    3. Recall opioid use neurobiology as it applies to the development of an opioid use disorder and relapse risk
    4. Summarize the laws regulating office-based opioid treatment including the Drug Addiction Treatment Act of 2000 and the Comprehensive Addiction and Recovery Act of 2016
    5. Summarize the clinical pharmacology, efficacy and safety of methadone, buprenorphine and naltrexone in treating opioid use disorder
    6. Identify and assess patients who are appropriate for treatment with medications for an opioid use disorder in an office-based setting
    7. Describe procedures for setting up office systems to support medication prescribing for opioid use disorder
    8. Describe procedures for initiating, stabilizing, maintaining, monitoring and modifying treatment of patients on buprenorphine or naltrexone
    9. Summarize the assessment and management of patients with psychiatric and medical co-morbidities associated with opioid use disorder
    10. Describe unique issues of treating adolescents, young adults, pregnant and postpartum patients maintained on medications for opioid use disorder
    11. Summarize acute and chronic pain management strategies for patients with an opioid use disorder
    12. Apply for a waiver to prescribe buprenorphine to patients with opioid use disorder

    For 24-Hour Treatment of Opioid Use Disorder Course issuing AANP CE Credit: Click Here


    This training is divided into two parts of 8 hours and 16 hours. If you have already completed the 8-hour DATA2000 course, you will only need to complete the second part of the 16-hour course.

    Legislation
    Comprehensive Addiction and Recovery Act (CARA)
    ASAM, AAPA and AANP have formed a collaborative to provide the 24-hour waiver training for physician assistants and nurse practitioners. The three organizations are authorized by statute to provide this training. Educational content has been identified and/or created to satisfy the 24-hour requirement as described in the Comprehensive Addiction and Recovery Act (CARA).

    HR6 - SUPPORT for Patients and Communities Act
    HR6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, added qualifying clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives to list of practitioners eligible to prescribe buprenorphine until October 1, 2023. The ASAM Treatment of Opioid Use Disorder Course is available for qualifying clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives.

    Qualify
    To qualify for a waiver, NPs, PAs, CRNAs, CNMs, and CNSs 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

    Please ensure that your state regulations allow you to prescribe buprenorphine and other medications to treat Opioid Use Disorder before you apply for the waiver. Some states may have overriding state legislation that will prevent NPs/PAs from prescribing these medications even if Federal law allows it. Click here to learn more about applying for the waiver. 

    1. Providers who wish to obtain a waiver to prescribe buprenorphine in office-based treatment of opioid use disorders.
    2. Clinicians and healthcare team members working with providers who prescribe buprenorphine in office-based treatment of opioid use disorders.

    ASAM would like to acknowledge the following supporters:

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

    Funding for this initiative was made possible (in part) by grant no. 1H79TI026793-01 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

  • Part 2: 16-Hour Waiver Training - AAPA

    Contains 30 Component(s), Includes Credits

    This product contains 16 hours of education.

    Welcome Part 2: 16-Hour Waiver Training, part of the 24-Hour Waiver Training. This course provides 16 hours of education needed for NPs, PAs, CRNAs, CNMs, and CNSs to receive a waiver to prescribe buprenorphine in an office-based setting. More information on waiver requirements can be found on the SAMHSA website. The curriculum covers: medical withdrawal management and maintenance; appropriate clinical use of FDA-approved medications for OUD treatment; initial and period patient assessment; addressing overdose, co-occurring disorders, and pain management; and counseling and recovery support services.

    To begin the online course, please ensure you are logged in (locate your name in the left-hand menu), then open the "Contents" tab, then locate the box that starts with  "1.1" in the first section. If you do not know your password, or you have forgotten it, select "Forgot Password" and you will be emailed a link to reset your password.

    After completing the online modules, corresponding quizzes, and applicable evaluations, you can claim credit for the course. If you have any questions, please contact education@ASAM.org.

    For 24-Hour Treatment of Opioid Use Disorder Course issuing AANP CE Credit: Click Here


    ASAM, AAPA and AANP have formed a collaborative to provide the 24-hour waiver training for physician assistants and nurse practitioners. The three organizations are authorized by statute to provide this training. Educational content has been identified and/or created to satisfy the 24-hour requirement as described in the Comprehensive Addiction and Recovery Act (CARA).

    To qualify for a waiver, 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, be supervised or work in collaboration with a qualifying physician to prescribe medications for the treatment of OUD 

    Please ensure that your state regulations allow you to prescribe buprenorphine and other medications to treat Opioid Use Disorder before you apply for the waiver. Some states may have overriding state legislation that will prevent NPs/PAs from prescribing these medications even if Federal law allows it. Click here to learn more about applying for the waiver.

    This training is divided into two parts of 8 hours and 16 hours. If you have already completed the 8-hour DATA2000 course, you will only need to complete the second part of the 16-hour course.

    Available Now for CNS, CRNA, and CNM!

    H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, added qualifying clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives to list of practitioners eligible to prescribe buprenorphine until October 1, 2023. The ASAM Treatment of Opioid Use Disorder Course is available for qualifying clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives. 

    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.

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

    AMA Credit Designation Statement: The American Society of Addiction Medicine designates this enduring material for a maximum of 16 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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

The collaborative of ASAM, AAPA and AANP identified and reviewed this content to provide the NP/PA training required by CARA.

The NP/PA 24-Hour Waiver Training is available for free in part by an unrestricted educational grant from Indivior.

The 16-hour product developed includes all additional education required by the Comprehensive Addiction and Recovery Act (CARA) for physician assistants to successfully apply for a waiver to prescribe buprenorphine for office-based treatment of opioid use disorders.