February 21, 2020
Buprenorphine Training Opens the Door to Understanding Epidemiology, Neurobiology, and Pharmacology of Addiction
AAPA 2018 Offers 8 of 24 hours of Buprenorphine Waiver training; Remaining 16 hours available online
By Kate Maloney
Drug overdose deaths have sharply increased in the United States since 2000. According to the Centers for Disease Control and Prevention (CDC), the majority of these drug overdose deaths (66 percent) involve an opioid. Between 2000 and 2016, more than 600,000 people died from drug overdoses, and the CDC estimates that, on average, 115 Americans die each day from an opioid overdose.
Medication-assisted treatment (MAT) is a promising option for many patients suffering from opioid-use disorders (OUD). The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that MAT is “the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a ‘whole-patient’ approach to the treatment of substance use disorders.” The three medications commonly used to treat opioid addiction are methadone, naltrexone, and buprenorphine. As part of the Comprehensive Addiction and Recovery Act (CARA), Congress expanded the authority to prescribe buprenorphine to additional healthcare providers – PAs included. PAs can now prescribe buprenorphine after completing 24 hours of training and obtaining their DEA X-waiver. AAPA 2018 offers an eight-hour Buprenorphine Waiver Training, helping PAs get that much closer to completing their training requirements. After attending the in-person training, PAs can complete their remaining 16 training hours online.
Jill Mattingly, DHSc, MMSc, PA-C, PA program director at Mercer University, spent much of her clinical career in addiction medicine. Realizing that most PAs had little or no exposure to patients with substance-use disorders until they were on the job, she began creating a robust substance-use curriculum for her PA students. Here she discusses the importance of buprenorphine training for PAs and why more PAs should obtain their waivers.
Why should PAs attend buprenorphine waiver training at AAPA 2018?
Mattingly: PA curriculum is usually lacking when it comes to addiction training. There is very little time in most programs to grasp all the aspects of the disease. The waiver program is a condensed training for the treatment of opioid-use disorder only, but the training opens the door to understanding epidemiology, neurobiology, and pharmacology of addiction. This training exposes PAs to treatment options and hopefully encourages continued training in all kinds of use disorders.
How will buprenorphine waiver training enhance PAs’ practice?
Mattingly: I believe that with knowledge comes confidence. By gaining knowledge from the buprenorphine waiver training, PAs will be more confident the next time they see the tell-tale signs of use disorder. They will know what useful and effective treatments they can employ immediately. Training will give PAs power to affect change in a timely manner.
How will more PAs with waivers help the opioid epidemic?
Mattingly: It will expand access to treatment for OUD. It will increase primary-care provider acumen in addiction treatment. PAs are on the front lines of the fight, and very few are trained in addiction medicine. Since many PAs practice outside the reach of large health systems in rural and underserved communities, they especially need their waivers, as their patients may be suffering from an OUD . They will need to be able to treat patients with an OUD cost effectively in their practice locations.
How do you see the areas of addiction medicine and MAT expanding in the future?
Mattingly: It’s past time for a wake-up call. MAT is only now gaining greater name recognition and respect as a viable treatment option for many substance-use disorders (SUD). In the future, I hope that addiction medicine will not be a unique specialty, but will be a part of all areas of medical practice. With increased training in MAT, we could see the diagnosis and treatment of SUD by PAs in many and varied specialties.
What is your advice for PAs who are interested in addiction medicine?
Mattingly: PA students can gain exposure to the field through Behavior Medicine rotations, so seek them out. Be aware that addiction medicine truly is a marriage of internal medicine and psychiatric medicine because of the high incidence of disease and co-morbid mental disorders.
Q: How can PAs become thought leaders in this field?
Mattingly: We need to add sufficient addiction training to PA school curriculum. PAs will then graduate with the knowledge, tools, and resources to treat opioid-use disorders in a timely, preventative, and cost-effective manner. Effectively trained and educated PAs could lead the way in expanding knowledge with case studies and research.
Join Mattingly and other PAs who are working towards obtaining the DEA x-waiver at AAPA 2018 in New Orleans on Friday, May 18. The eight-hour session will include coverage of buprenorphine-related legislation, neurobiology, epidemiology, pharmacology, and an overview of implementing Office-Based Opioid Treatment (OBOT). Learn more and sign up today.
Kate Maloney is AAPA’s senior manager, corporate communications. Contact her at [email protected].