- Get Started: Use the BIG blue button ABOVE this box to go through the demographics, activity description, and the pre-test/pre-survey.
- Complete Training: Once you have completed the steps to get started, your module progress can be found above. There are 25 modules in this DATA 2000/CARA 2016 buprenorphine training program. You must complete all pages in each module, from start to finish. CARA requires that you spend at least 24 hours on training to qualify for a waiver. This is Part 1 of that requirement and is 8 hours/10 modules. Please pace yourself appropriately.
- Get Credit: When you finish all the modules in Part 1, take the post-test, post-survey and post needs survey, and request continuing education credit.
- We will send your name to SAMHSA when you have successfully completed the 24-hour training.
- Submit the online Buprenorphine Waiver Notification form. List ASAM as the training provider.
Reminder: Spending more than 15 minutes on any page will result in being logged out. To keep from being automatically logged out, avoid bookmarking module pages. Instead, please be sure to always access the activity through the activity homepage, to ensure being able to progress through the modules correctly.
Updates: Updated to the Comprehensive Addiction and Recovery Act of 2016 (CARA) and Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder - Review and Update (SAMHSA, 2016).
Goal: To provide a core training to Nurse Practitioners and Physician Assistants who meet the requirement of the federal CARA 2016 law (which includes an 24 hour training experience), in order to increase the number of providers who are knowledgeable about and qualified to prescribe buprenorphine to their patients with opioid use disorder.Part 1:
Data from the 2013 National Survey on Drug Use and Health shows that a serious epidemic of opioid misuse continues at a rate similar to the previous 5 years, with 4.5 million people aged 12 or older engaging in misuse of pain relievers (SAMHSA, 2014). Data from the following year cannot be compared due to a refinement in the definition of misuse to mean any way not directed by a doctor, but shows that the epidemic continues at significantly high rate (Hughes et al., 2016). With the new definition of misuse, 12.5 million Americans or 4.7% of the American population age twelve or older had misuse of pain relievers in the past year. Of those people, approximately 63% said that their opioid misuse was to relieve pain. Past year use of heroin continued to rise and was reported by 828,000 people age twelve or older in 2015. The rate of overdose deaths is also steadily increasing. In 2015, over 22,000 deaths involved prescription opioids, which is an increase from 19,000 in 2014, which is nearly a 16% increase (CDC, 2016).
Although the number of people receiving treatment for opioid use disorder has increased, the number of people being treated is still only a small fraction of those needing treatment: Past year treatment for prescription pain reliever misuse was still only received by 746,000 individuals in 2013 (SAMHSA, 2014).
Buprenorphine is a safe and effective treatment for opioid use disorder that offers patients a more widely available, accessible, convenient treatment option as compared to traditional opioid treatment programs (OTP) (SAMHSA, 2004; SAMHSA, 2016). The Drug Addiction Treatment Act (DATA) of 2000—an amendment to the Controlled Substances Act — allowed physicians who are not part of an OTP to prescribe buprenorphine with additional training and a waiver to the Controlled Substances Act. The Comprehensive Addiction and Recovery Act of 2016 (CARA) added nurse practitioners and physician assistants to the list of providers who can train to prescribe buprenorphine and become waivered.
The law requires physicians to complete an 8-hour buprenorphine training conducted by an approved organization in order to prescribe it; the required training for nurse practitioners and physician assistants is 24 hours. While buprenorphine is relatively safe, there are risks of overdose and death due to buprenorphine and there is a risk of diversion (FSMB, 2013), which, in addition to skills needed to prescribe the medication effectively for each individual, are among the reasons for the mandatory training.
This buprenorphine training activity prepares providers to prescribe buprenorphine safely and effectively to address needs of the millions of Americans with opioid use problems. The activity has been developed to meet the DATA 2000 training guidelines as defined in Public Law 106-310-106th Congress as well as the Comprehensive Addiction and Recovery Act of 2016 (S 524, Title III, Section 303-114th Congress) and is endorsed by the American Society of Addiction Medicine, one of the approved training organizations named in DATA 2000. The activity content was initially based upon SAMHSA’s 2004 publication Treatment Improvement Protocol (TIP) #40: Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction and follow the Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Office (FSMB, 2013). It has been edited to SAMHSA's Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder - Review and Update (2016), ASAM's National Practice Guideline For the Use of Medication in the Treatment of Addiction Involving Opioid Use (2015), and the CDC's guidelines on opioid treatment (Dowell et al., 2015) as well as CARA 2016. The courses are regularly reviewed and updated by ASAM members who are experts in the field of addiction medicine and buprenorphine treatment.
Educational Objectives:After completing this activity participants will be able to:
Expand your practice to comply with the regulations and requirements of office-based buprenorphine treatment so that you can prescribe buprenorphine to your patients when appropriate
Relate buprenorphine's pharmacological properties to its drug effects and understand the physiological effects of opioids and opioid treatments on patients
Identify, assess, and diagnose opioid use disorder in your patients
Use medical and substance use disorder history information to assess your patients in terms of suitability for treatment with buprenorphine
Provide effective and successful treatment to your patients throughout the phases of buprenorphine treatment: induction, maintenance, and discontinuation, and deal with complications that arise
Assess and adapt treatment guidelines to best treat your patients from specific patient populations, including those with psychiatric comorbidities, adolescents, the elderly, pregnant women, methadone transfers, and patients with pain
Prescribe, refer, or implement appropriate psychosocial therapies for treating opioid use disorder for your patients
Modules in this Training Activity
About Prescribing Buprenorphine v4.0
Impact of Opioid Use Disorder v4.0
Pharmacology of Buprenorphine and Other Opioids v4.0
Detection and Diagnosis of Opioid Use Disorder v4.0
Assessing Patients for Buprenorphine Treatment v4.0
Buprenorphine Protocol: Induction v4.0
Buprenorphine Protocols: Maintenance and Discontinuation v4.0
Buprenorphine Protocols: Methadone Patients and Other Subpopulations v4.0
Managing Patients in a Buprenorphine Practice v4.0
Regulations for Office-Based Opioid Treatment v4.0
Audience and Accreditation
|AMA PRA Category 1 Credit(s)™||9hr(s)||11/21/16||11/21/17|
Activity Credit: Obtaining credit for participation in this activity requires that you complete the pre-assessments, work through the modules (including all in-module interactive activities), complete the post-assessments with a 70% score on the post-test, and then request credit. At the end of the activity, you will be instructed on how to print out a certificate for your records.
Time Requirement: Keep track of the amount of time it takes you to complete this activity. You will be required to spend a set amount of time in order to claim credit. You should claim credit only for the time actually spent in the activity.
Technical Requirement: To participate in this activity, you will need a computer, an Internet connection, and a Web browser. This activity requires Chrome, Firefox, and IE7 or higher.