All Drug Enforcement Administration (DEA)-registered practitioners are required to meet a one-time, 8-hour training requirement on the treatment and management of patients with opioid use disorder or other substance use disorders per Section 1263 of the Consolidated Appropriations Act of 2023 (also known as the Medication Access and Training Expansion [MATE] Act). The DEA training requirement takes effect on June 27, 2023.
The original version of this legislation required a 24-hour training requirement for nonphysician prescribers. The American Academy of Physician Associates (AAPA) said it did not support the original training requirement and had significant engagement with Congressional lawmakers that persuaded Congress to establish a uniform training requirement of 8 hours.
Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that the 8-hour training content should be related to the prevention, recognition, and care of people with substance use disorders including those with concurrent pain and/or psychiatric and medical co-morbidities. Previous and existing training provided by the American Association of Nurse Practitioners (AANP), AAPA, and several other organizations can satisfy the requirement. Past DATA-Waiver training also counts toward the 8-hour training requirement, according to SAMHSA.
Clinicians also meet this requirement if they graduated within the past 5 years from a medical, advanced practice nursing, or PA school in the United States that included successful completion of an opioid or other substance use disorder curriculum of at least 8 hours. This curriculum must have included teaching on the treatment and management of patients with opioid and other substance use disorders, including the appropriate clinical use of all drugs approved by the Food and Drug Administration for the treatment of a substance use disorder, according to SAMHSA. Practitioners who are board certified in addiction medicine or addiction psychiatry from the American Board of Medical Specialties, American Board of Addiction Medicine, or American Osteopathic Association also meet the 8-hour training requirement.
Although practitioners are not required to supply proof of training, they are required to check a box on their online DEA registration form regarding the requirement when they renew their registration. DEA has not communicated any details regarding any intent to audit PAs who indicate they have satisfied this requirement. The AAPA encourages PAs to maintain documentation and CME certificates of any associated training they have completed.
The signing of the Consolidated Appropriations Act of 2023 also eliminated the DATA-Waiver (X-Waiver) registration requirement for clinicians to prescribe buprenorphine for opioid use disorder (Table).
Table. Summary of the Consolidated Appropriations Act of 2023 Changes
|An X-Waiver registration is no longer required to prescribe buprenorphine for opioid use disorder|
|All prescriptions for buprenorphine now only require a standard DEA registration number that includes Schedule III authority; previously used DATA-Waiver registration numbers are no longer needed|
|Limits or patient caps were eliminated on the number of patients a prescriber may treat for opioid use disorder with buprenorphine|
|The Act does not impact applicable state laws or regulations|
AAPA President Jennifer M. Orozco, DMSc, PA-C, DFAAPA, called the elimination of the decades-long X-Waiver requirement a “game changer” in addressing the nation’s opioid epidemic. In response to the new legislation, the SAMHSA strongly encouraged all eligible practitioners to screen each patient for opioid use disorder and offer access to buprenorphine if permissible under state law.
“Given the urgency of the nation’s overdose crisis, the importance of having medical professionals equipped with such training cannot be overstated,” said SAMHSA.
American Academy of Physician Associates. New DEA requirement for registered practitioners to complete SUD, OUD training to take effect June 27. Updated April 3, 2023. Accessed April 28, 2023. https://www.aapa.org/news-central/2023/04/new-dea-requirement-for-registered-practitioners-to-complete-sud-oud-training-to-take-effect-june-27/
Substance Abuse and Mental Health Services Administration. Recommendations for curricular elements in substance use disorders training. Updated April 24, 2023. Accessed April 28, 2023. https://www.samhsa.gov/medications-substance-use-disorders/provider-support-services/recommendations-curricular-elements-substance-use-disorders-training