New Guidelines for Buprenorphine Treatment Provide Exemption to Burdensome Training Requirements
AAPA Applauds HHS, Administration for Removing Barriers to Opioid Use Disorder Treatment
April 28, 2021
The Department of Health and Human Services (HHS) recently announced new buprenorphine practice guidelines that exempt PAs and other qualified prescribers from federal certification requirements related to training, counseling, and other ancillary services that were a part of the process for obtaining a waiver to treat up to 30 patients with buprenorphine. The new Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder provide an exemption to the training requirement for providers treating up to 30 patients. The previous guideline that required PAs to obtain 24 hours of training before prescribing buprenorphine for SUD was often a barrier to treatment.
Previously, guidelines that were announced but not implemented in early January would have provided an exemption for physicians to prescribe buprenorphine for Medication-Assisted Treatment (MAT) purposes to up to 30 patients without obtaining a waiver, but did not make the same change for PAs or nurse practitioners (NPs). This was an oversight that AAPA and the American Association of Nurse Practitioners (AANP) worked together to bring to HHS’s attention. In January, AAPA and AANP submitted a joint letter to the U.S. HHS Secretary asking the agency to remove barriers for PAs and NPs, and underscoring the critical role both professions play in addressing opioid use disorder.
According to the Centers for Disease Control and Prevention (CDC), as of June 2020, 13% of Americans reported starting or increasing substance use as a way of coping with stress or emotions related to COVID-19.
Overdoses have also spiked since the onset of the pandemic. More than 90,000 drug overdose deaths are predicted to have occurred in the United States in the 12 months ending in September 2020, the highest number of overdose deaths ever recorded in a 12-month period, according to the CDC.
“The reports of increased substance abuse and overdoses during the pandemic are of great concern to PAs across the country – but especially those whose patients have urgently needed treatment for opioid abuse disorder,” said AAPA President and Chair of the Board Beth R. Smolko, DMSc, MMS, PA-C, DFAAPA. “These updated guidelines for buprenorphine treatment will ensure PAs are better positioned to quickly respond when their patients require access to potentially lifesaving treatment.”
Under the updated guidelines, practitioners including PAs are required to obtain a waiver under the Controlled Substances Act by submitting a Notice of Intent to Substance Abuse and Mental Health Services Administration (SAMHSA) under established protocols, before treating patients with buprenorphine for opioid use disorder. While training is no longer required for PAs treating up to 30 patients, free CME on buprenorphine and opioid use disorder is available for PAs looking to develop their clinical skills in this area.
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