The American Academy of Addiction Psychiatry (AAAP), has been awarded a three year grant in partnership with the American Osteopathic Academy of Addiction Medicine (AOAAM) and the American Psychiatric Association (APA), by the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration, to provide training in office based treatment of opioid use disorders for practicing physicians and physicians-in-training nationwide. This project is known as the Physicians’ Clinical Support System – Buprenorphine (PCSS-B) because at present only buprenorphine is a scheduled medicine FDA approved for office-based treatment of opioid use disorders. The PCSS-B project provides the 8 hours needed to obtain the waiver to prescribe buprenorphine in office-based treatment of opioid use disorders.
The program is recommended for physicians in primary care, pain management, psychiatric, HIV and addiction medicine however, other professionals (non-physicians, NPs, PA-Cs) are also invited but will not be able to be eligible for the waiver. At this time, only M.D.s or D.O.s are eligible to prescribe.
Who we are
The PCSS-B is a collaboration among the AAAP, the AOAAM and the APA. Each of these three organizations are authorized by the Drug Addiction Treatment Act of 2000 (DATA 2000) to provide training leading to waiver eligibility for physicians who want to offer offi ce-based treatment of opioid use disorders using buprenorphine in their practices. Since 2001, AAAP, AOAAM, and APA have trained over 10,000 physicians who have received a waiver that allows them to engage in office-based treatment of opioid use disorders.
Why this is important?
Opioid dependence is epidemic in the United States, with increasing numbers addicted to heroin and burgeoning abuse of prescription opioid analgesics. Buprenorphine, the most recent addition to the pharmacotherapies available to treat opioid dependence, is novel among the opioid pharmacotherapies because of its partial agonist properties. It has been placed on Schedule III and is available by prescription from a physician’s office-based practice.
While we have made progress in training physicians, the gap in providing effective treatment of opioid use disorders continues to widen, moving beyond heroin addicted individuals to a much larger and diverse segment of the population. This increase is predominantly due to an alarming increase in addiction to prescription opioid analgesic medications.
In 2009, 7 million Americans age 12 and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once in the year prior to being surveyed. In 2009, 180,000 Americans age 12 and older had abused heroin at least once in the year prior to being surveyed. While not all of these individuals will go on to become addicted to opioids, a significant percentage of them will. The National Institute on Drug Abuse estimated that 23% of those who try heroin will go on to become addicted to the drug. It is also estimated that 1.9 million misusers of prescription opioid analgesic medications meet diagnostic criteria for an opioid use disorder and need treatment.
Recognizing the impact of this addiction, as well as learning how to treat opioid use disorders, is an important step in combating this ever growing medical problem.
- National Survey on Drug Use and Health. (2010). Retrieved from Substance Abuse and Mental Health Services Administration
- NIDA InfoFacts: Heroin. (2010). Retrieved from National Institute on Drug Abuse
- Understand the federal Drug Abuse Treatment Act (DATA) of 2000 and the subsequent revisions that lists the criteria needed for Office Based Opioid Treatment (OBOT) utilizing;
- List the criteria for establishing the diagnosis of opioid dependence;
- Distinguish between spontaneous withdrawal and precipitated withdrawal and the appropriate methods of buprenorphine induction;
- Describe and contrast the functions of full mu agonists, partial agonists and antagonists;
- Understand the interplay between pain and addiction and how buprenorphine can be used to help stabilize these patients;
- Describe the basic approach used in at least three different types of non-pharmacological treatment of opioid dependence;
- Describe three symptoms of opioid withdrawal or intoxication that mimic symptoms of a psychiatric disorder;
- Describe at least three factors to consider in determining if the patient is an appropriate candidate for office-based treatment with buprenorphine;
- Describe at least three areas that should be covered in the rules and expectations communicated to patients during the patient assessment process;
- List at least three situations in which patient information, with patient identity, can be shared under current laws protecting the patient’s confidentiality 42 CRF and HIPPA;
- Understand and minimize buprenorphine misuse and diversion;
- Be aware of the issues of drug interactions of buprenorphine and pediatric exposures.
Half and half trainings
In an effort to provide training in a way that is more flexible for both practicing physicians and physicians-in-training, AAAP sponsored the creation of the Half and Half course. The first half of the course is 3.75 hours of CD-based training. This CD contains training on substance abuse treatment, opioids, and the use of buprenorphine in the treatment of opioid use disorders from office-based practices. An examination on the CD must be printed and successfully completed as part of the process to obtain a waiver for prescribing buprenorphine.
The other half of the course is a face-to-face, classroom-style training with small groups in a 4.25 hour training. The training focuses on specifics of treating patients with opioid use disorders in office-based settings and clinical vignettes to help trainees think through “real life” experiences in opioid use disorders treatment.
The combined CD and face-to-face training will provide the required 8 hours needed to obtain the waiver to prescribe buprenorphine in office-based treatment of opioid disorders. If you have any questions about the Half and Half course please contact PCSS-B at email@example.com or 888-5PCSSB-4U.
|7:30 a.m.||Registration and Breakfast|
Overview: Opioid Dependence Treatment with Buprenorphine/Naloxone
Clinical Use of Buprenorphine
Overview of Clinical Tools
|12:45 p.m.||Adjourn (Boxed Lunches Available)|
Self-study session on cd-rom and exam
Materials will be mailed to you.
- Overview of Office-Based Treatment of Substance Use Disorders
- Review of Opioids
- Introduction to Opioid Dependence Treatment with Buprenorphine/Naloxone
- Special Aspects of the Treatment of Substance Use Disorders
- Special Treatment Populations And The Use Of Buprenorphine
Anthony Miller, M.D.
Staff Psychiatrist, Director of Addictive Disorder Services, Iowa City Veterans Affairs Health Care System, Clinical Associate Professor of Psychiatry, University of Iowa Carver College of Medicine
AOA: This activity has been planned and implemented in accordance with the essential areas and policies of the American Osteopathic Association (AOA). Des Moines University is accredited by the AOA and approves this activity for a maximum of 4.0 hours of AOA Category 2-A CME credits.
AAFP: This course has been reviewed and is acceptable for up to 4.0 credits by the American Academy of Family Physicians (AAFP). AOAAM will distribute certificates of attendance according to the mandatory sign-in/out documentation conducted at face-to-face session on May 4th. Physicians should claim only the credit commensurate with the extents of their participation in the activity.
IBON: Des Moines University Continuing Medical Education (provider #112) is approved by the Iowa Board of Nursing as an accredited provider. This program has been reviewed and approved for 4.8 continuing education contact hours.
Other: Attendees will be given a certificate of participation for a maximum 4.0 continuing education hours.
Funding for this training was made possible (in part) by contract #1H79T1022022 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 or Des Moines University; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government or Des Moines University.
Hot Topics Buprenorphine Treatment – Webinar Series
Hot Topics in Buprenorphine Treatment is a PCSS-B sponsored webinar series that addresses a variety of clinical topics, as well as emerging legislative, regulatory, and practice management issues. Scheduled on the second Tuesday of each month from noon to 1 p.m. Eastern, the sessions feature national clinical experts, researchers, and government officials. Hot Topics is designed as an ongoing educational experience for physicians who have completed buprenorphine training, but all interested physicians and clinicians are invited to participate. Information and scheduling can be accessed at www.pcssb.org. Recordings of past webinars can also be accessed through the site.
- Important Medication Update
- Training Database (NEW)!
- Upcoming Waiver Eligibility Trainings
- How to prepare for a DEA Inspection!
- Buprenorphine Prescribing Practices and Exposures Reported to a Poison Center — Utah, 2002–2011 (NEW)
- FDA Announces REMS Training: All Opioid Prescribers are Encouraged to Take these Trainings
- NEW SAMHSA Advisory!
For all questions regarding the educational content and waiver, please contact:
For all other questions, please contact:
Professionals – $50
DMU students and residents - $0
- All cancellations/refund requests (minus a 25% administrative fee), must be received in writing at least seven (7) business days prior to the CME activity starting date.
- For cancellations received less than seven (7) business days prior to the activity starting date, a 50% administrative fee will apply.
- You may transfer your registration fee to a colleague if you contact the DMU CME office three (3) business days prior to the activity starting date.
- Individuals who fail to attend the activity (no-shows) will not be entitled to any refund. Forfeited fees may not be applied to subsequent activities.