Safe_Opioid_Use_Task_Force

FROM LARA:
June 21, 2023

To all controlled substance licensees:
Most practitioners are now aware that Congress has passed the Mainstreaming Addiction Treatment (MAT) Act that removed the federal “DATA 2000” or “DATA-Waiver Program,” and the Medication Access and Training Expansion (MATE) Act that established a one-time training on substance use disorder for practitioners who prescribe controlled substances when they obtain or renew their Drug Enforcement Administration (DEA) registration. In light of these changes, which are intended to educate practitioners and reduce barriers to obtaining medications for opioid use disorder (OUD) by eliminating burdens on providers who currently prescribe medications and new providers who wish to treat patients with OUD, the Bureau of Professional Licensing (BPL) would like to convey the following corresponding changes at the state level:

• The new DEA one-time 8-hour training requirement is effective June 27, 2023. Effective on this date, or the date on which the DEA requires the 8-hour training in the event the effective date is delayed, and until further notice, a practitioner required to attend a one-time opioid and controlled substances awareness training by the state’s Controlled Substances Rules, may use the 8 hours of training that is accepted by the DEA for their controlled substances registration to also meet the state’s required one-time training on opioids and other controlled substances awareness.

• In addition, R 338.3163 that limits prescribing, dispensing and administering a controlled substance to an individual with a substance use disorder will not be enforced by BPL until the rule is either modified or rescinded. This rule limited the circumstances under which a practitioner could treat an individual with substance use disorder, as well as the number of individuals that could be treated. All other laws and rules, both federal and state, must still be followed.

For more information about the elimination of the DATA-Waiver Program, and DEA’s 8-hour substance disorder training, please refer to the following websites: 
 https://www.samhsa.gov/medications-substance-use-disorders/removal-data-waiver-requirement
 https://www.deadiversion.usdoj.gov/pubs/docs/MATE_training.html 
 MATE_Training_Letter_Final.pdf (usdoj.gov)

Questions may be sent to [email protected].

Thank you,
Bureau of Professional Licensing
Licensing Division


New DEA Training Requirement Takes Effect June 27

Who Is Impacted, Eligible Training, and Attestation
As mandated by the federal Medication Access and Training Expansion (MATE) Act of 2021, beginning June 27, 2023, prescribers of controlled substances in schedules II, III, IV, and V must complete a one-time eight-hour training on managing patients with substance use disorders prior to their first registration or renewal of their Drug Enforcement Agency license.

This means the eight-hour training requirement must be met before:

  • Applying for a DEA license for the first time on/after June 27, 2023; or
  • One’s next DEA license renewal date on/after June 27, 2023.

This is a one-time DEA requirement. Once you’ve attested to completing eight hours of required training, you will not need to complete additional training for subsequent DEA renewals. It is important to note that for medical licensure in Michigan, physicians must still obtain three hours of training on pain and symptom management every 3-year licensure cycle.

LINKS:
DEA letter to Registered-Practitioners
Provider Clinical Support System: Requirements for training for Medication Assistant Treatment as part of the MATE Act


Questions or comments for the Safe Opioid Task Force

The MOA established the Safe Opioid Task Force in 2015. The Task Force works to advocate on behalf of physicians and the patients they serve on the issues of preventing addiction, treating addiction, and providing information on safe prescribing guidelines.

Questions or Comments
If you have questions, comments or concerns regarding the information being shared, please use this form. Your submission will be forwarded to members of the Task Force. The time is takes to reply may  depend on the issue. 

Safe Opioid Task Force Question/Comment form

Proposed CDC Clinical Practice Guideline for Prescribing Opioids - Public Comments are being accepted

Proposed CDC Clinical Practice Guideline for Prescribing Opioids–United States, 2022 that can be found in the following URL within the Federal Register - Federal Register :: Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids. This update provides key revisions from the 2016 version, particularly for those who have chronic disease that incites severe intractable and largely incurable pain. 

Prescribing Opioids—United States, 2022 (the clinical practice guideline). The clinical practice guideline updates and expands the CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016, and provides evidence-based recommendations for clinicians who provide pain care, including those prescribing opioids, for outpatients age 18 years and older with acute pain (duration less than 1 month), subacute pain (duration of 1-3 months), or chronic pain (duration of 3 months or more), not including sickle cell disease-related pain management, cancer pain treatment, palliative care, and end-of-life care. The clinical practice guideline includes recommendations for primary care clinicians (including physicians, nurse practitioners, and physician assistants) as well as for outpatient clinicians in other specialties (including those managing dental and post-surgical pain in outpatient settings and emergency clinicians providing pain management for patients being discharged from emergency departments). This voluntary clinical practice guideline provides recommendations and does not require mandatory compliance; and the clinical practice guideline is intended to be flexible so as to support, not supplant, clinical judgment and individualized, patient-centered decision-making.

CDC Clinical Practice Guideline for Prescribing Opioids
2016 vs. 2022 CDC Opioid Guideline comparison (PDF) from the U.S. Pain Foundation

 5 Strategic Pillars to Combat opioid abuse

The Michigan Osteopathic Association (MOA) has developed a strategy for combating the opioid crisis facing Michigan. The MOA's "5 Strategic Pillars" were developed based on recommendations from the MOA Presidential Task Force on Safe Opioid Use, the Michigan Governor's Task Force and The Office of the White House.

On this page, you will find news and info about efforts from the MOA and around Michigan to lessen the burden of the opioid epidemic, a full cadre of resources and useful links for both providers and patients and a section on the MOA Presidential Task Force on Safe Opioid Use.

Goal - reduce opioid-related deaths and morbidity, while we treat patients with pain and/or addiction with compassion and expertise.
Click here for the 5 Strategic Pillars


Resources

There are many online resources available to learn more about the opioids issue in Michigan. The MOA has compiled some web links for you.

Safe Drug Disposal Information for Michigan

Providers' Clinical Support System For Opioid Therapies

Balancing Pain Management and Prescription Opioid Abuse

Opioid painkiller prescribing varies widely among states

Prescription Painkiller Overdoses

Prescription Painkiller Overdoses in the US

Gov. Rick Snyder forms task force to address prescription drug and opioid problems in Michigan

MAPS Report 2014- Michigan.gov (PDF)

America's Addiction to Opioids: Heroin and Prescription Drug Abuse

Prescription Opioid and Heroin Abuse 

Incidence of Neonatal Abstinence Syndrome — 28 States