Medications for opioid use disorder (MOUD) significantly reduce morbidity and mortality from opioid use disorder (OUD). To prescribe MOUD, physicians must obtain a DEA waiver through requirements outlined in the Drug Addiction Treatment Act of 2000 (DATA 2000). We developed an Addiction Medicine curriculum that features DATA 2000 waiver training at the Robert Larner, MD College of Medicine (LCOM).
Methods
All third-year medical students completed a virtual DATA 2000 waiver training at the commencement of clinical clerkships. We conducted a curriculum needs assessment followed by pre- and post-training surveys to evaluate MOUD pharmacology knowledge and best prescribing practices.
Results
Of LCOM students surveyed, 77.6% reported interest in being waivered to prescribed MOUD for OUD treatment. Third-year medical students demonstrated increases in both MOUD Pharmacology Knowledge from 64.2% to 84.8% (chi-squared = 40.8; p < .001) and MOUD Best Prescribing Practices from 55.9% to 75.2% (chi-squared = 29.9; p < .001).
Discussion
Surveys showed the majority of students felt waiver training was relevant to their future practice. An online DATA 2000 waiver training format effectively improved student knowledge of MOUD. Conclusion: This curriculum exposed medical students to DATA 2000 waiver training, MOUD pharmacology and best practices, and increased the number of future physicians eligible to treat OUD using MOUD.
FudalaPJ, BridgeTP, HerbertS, . Office-based treatment of opiate addiction with a sublingual-tablet formulation of buprenorphine and naloxone. N Engl J Med. 2003;349(10):949–958.
4.
LingW, CasadonteP, BigelowG, . Buprenorphine implants for treatment of opioid dependence: a randomized controlled trial. JAMA. 2010;304(14):1576–1583.
5.
LiebschutzJM, CrooksD, HermanD, . Buprenorphine treatment for hospitalized, opioid-dependent patients: a randomized clinical trial. JAMA Intern Med. 2014;174(8):1369–1376.
6.
MattickRP, BreenC, KimberJ, DavoliM.Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev. 2014;(2):CD002207.
7.
DegenhardtL, RandallD, HallW, LawM, ButlerT, BurnsL.Mortality among clients of a state-wide opioid pharmacotherapy program over 20 years: risk factors and lives saved. Drug Alcohol Depend. 2009;105(1–2):9–15.
8.
MaJ, BaoY-P, WangR-J, . Effects of medication-assisted treatment on mortality among opioids users: a systematic review and meta-analysis. Mol Psychiatry. 2019;24(12):1868–1883.
9.
Drug Addiction Treatment Act of 2000, 21 USC 801 §3501-3502 (2000).
Pub L No. 115-271. 132 Stat 3894-4143. Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act 2018.
12.
McGintyEE, StoneEM, Kennedy-HendricksA, BachhuberMA, BarryCL.Medication for opioid use disorder: a national survey of primary care physicians. Ann Intern Med. 2020;173(2):160–162.
13.
HaffajeeRL, BohnertASB, LagisettyPA.Policy pathways to address provider workforce barriers to buprenorphine treatment. Am J Prev Med. 2018;54(6 Suppl 3):S230–S242.
14.
AndrillaCHA, MooreTE, PattersonDG, LarsonEH.Geographic distribution of providers with a DEA waiver to prescribe buprenorphine for the treatment of opioid use disorder: a 5-year update. J Rural Health. 2019;35(1):108–112.
BrooklynJR, SigmonSC.Vermont Hub-and-Spoke Model of care for opioid use disorder: development, implementation, and impact. J Addict Med. 2017;11(4):286–292.
Substance Abuse and Mental Health Services Administration.Medications for Opioid Use Disorder. Treatment Improvement Protocol (TIP) Series 63. Publication No. PEP20-02-01-006. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2020.
26.
Valenstein-MahH, HagedornH, KayCL, ChristopherML, GordonAJ.Underutilization of the current clinical capacity to provide buprenorphine treatment for opioid use disorders within the Veterans Health Administration. Subst Abus. 2018;39(3):286–288.
27.
ThomasCP, DoyleE, KreinerPW, . Prescribing patterns of buprenorphine waivered physicians. Drug Alcohol Depend. 2017;181:213–218.
28.
ZerboE, TrabaC, MatthewP, . DATA 2000 waiver training for medical students: lessons learned from a medical school experience. Subst Abus. 2020;41(4):463–467.
29.
KernDE, ThomasPA, HughesMT, eds. Curriculum Development for Medical Education: A Six-Step Approach. 2nd ed. Baltimore, MD: Johns Hopkins University Press; 2009.
30.
McCance-KatzEF, GeorgeP, ScottNA, DollaseR, TunkelAR, McDonaldJ.Access to treatment for opioid use disorders: medical student preparation. Am J Addict. 2017;26(4):316–318.
