Fighting substance use disorders is a big challenge for American veterans and their communities. AOAAM past President, Anthony Dekker, DO, was a recent contributor to the article in Media Planet, “Help is on the Way for Veterans Caught in the Opioid Crisis.” Read the article.
Apr 17, 2017 Clinical Essentials from MMWR Morb Mortal Wkly Rep
Why this matters
Somerville NJ, O'Donnell J, Gladden RM, Zibbell JE, Green TC, Younkin M, Ruiz S, BabakhanlouChase H, Chan M, Callis BP, Kuramoto-Crawford J, Nields HM, Walley AY. Characteristics of Fentanyl Overdose - Massachusetts, 2014-2016. MMWR Morb Mortal Wkly Rep. 2017;66(14):382-386. doi: 10.15585/mmwr.mm6614a2. PMID: 28406883
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Psychological Consequences of the American Civil War
Author: R. Gregory Lande
The conclusion of America's Civil War set off an ongoing struggle as a fractured society suffered the psychological consequences of four years of destruction, deprivation and distrust. Veterans experienced climbing rates of depression, suicide, mental illness, crime, and alcohol and drug abuse. Survivors, leery of conventional medicine and traditional religion, sought out quacks and spiritualists as cult memberships grew. This book provides a comprehensive account of the war-weary fighting their mental demons.
Paperback: 256 pages / Publisher: McFarland (December 20, 2016) / Language: English
ISBN-10: 1476667373 / ISBN-13: 978-1476667379
Click here to view the October 2016 Addiction Education News - COPE
Click to view SAMHSA’s presentation on “Understanding the Buprenorphine Final Rule for a Patient Limit of 275”.
Physicians who have prescribed buprenorphine to 100 patients for at least one year can now increase their patient limits to 275 under new federal regulations. Read CSAT's Dear Colleague Letter (PDF | 234 KB) on the new rule.
The Understanding the Final Rule for a Patient Limit of 275 (PDF | 163 KB) guidance document will help you determine whether you are eligible to request the new, higher limit on the patients that you may treat based on your credentials or features of your practice setting. You may also review the final rule in the Federal Register for further information.
If you wish to be considered for the higher limit please complete the online Waiver Notification Form SMA-167. SAMHSA reviews applications within 45 days of receipt. For more information, send an email to firstname.lastname@example.org or call 866-BUP-CSAT (866-287-2728).
The Senate earlier this week passed the Comprehensive Addiction and Recovery Act (CARA).
The bill, which focuses on treating substance use disorder as a chronic illness rather than a criminal offense, expands education and prevention efforts, strengthens prescription drug monitoring programs, and increases first responder access to naloxone. The bill also allows nurse practitioners and physician assistants to prescribe buprenorphine with some restrictions.
The Department of Health and Human Services (HHS) issued a final rule on July 6, 2016 to increase access to Medication Assisted Treatment (MAT) with buprenorphine. This Rule will become effective on August 5, 2016. Below are key points that outlines which practitioners are eligible for an expanded patient limit of 275. (To read the entire rule click here)
Who is Eligible for a Patient Limit of 275 Under the Final Rule?
Under routine conditions, a practitioner would qualify for the higher limit in one of two ways:
The purpose of offering the 275 patient limit to practitioners in these two categories is to recognize the benefit offered to patients through: the advanced training and maintenance of knowledge and skill associated with the acquisition of subspecialty certification; and; the higher level of direct service provision and care coordination envisioned in the qualified practice setting.
In addition to ensuring higher quality of care, the criteria for the higher limit is intended to minimize the risk of diversion of controlled substances to illicit use and accidental exposure that could result from increased prescribing of buprenorphine.
Route 1 - Subspecialty Certification:
A practitioner with board certification in addiction would have the training and experience necessary to recognize and address behaviors associated with increased risk of diversion.
Route 2 – A Qualified Practice Setting (QPS)
The QPS is an alternative to advanced certification to acquire the new 275 patient limit. If you terminate your relationship with a QPS you return to the 100 patient limit.
What is a QPS?
The Higher 275 patient limit must be applied for every 3 years.
Final documentation construction is pending and a form will be available at www.samhsa.gov.
The Higher 275 patient limit may be revoked if there are violation of good practices.
Under the new increase, if you are outside of the standard of care, action can be taken and you will lose the waiver for the new limit.
Besides numbers what is the difference between the lower limit and the higher limit?
AOAAM applauds SAMHSA for taking a conservative approach
in raising the limit to prescribe buprenorphine for SUD
July 6, 2016: Today the Obama Administration took further action to address prescription opioid and the heroin epidemic. The Department of Health and Human Services (HHS), through the Substance Abuse and Mental Health Services Administration, is issuing a final rule to increase from 100 to 275 the number of patients that qualified physicians who prescribe buprenorphine for opioid use disorders can treat. Providers, policymakers, advocates, and experts have pointed to the current 100 patient limit for buprenorphine prescribing as a barrier to opioid use disorder treatment. AOAAM is pleased that SAMHSA raised the number far below the 500 limit that some had proposed, and also set up safeguards to prevent diversion. The rule aims to increase access to medication-assisted treatment and associated behavioral health supports for tens of thousands of people with opioid use disorders, while preventing diversion.
“Clinics throughout the country, particularly in urban areas, have had long lists of people waiting to receive buprenorphine, an opioid partial agonist. The number goes up from 100 to 275 patients in August. The line gets shorter; that is the beginning. I want to thank President Barak Obama, HHS Secretary Sylvia Burwell and all the staff burning midnight oil at SAMHSA, “says AOAAM President William Morrone, DO.
In addition to raising the proposed patient limit from 200 to 275, the final rule revised the qualifications for the higher limit to include board certification in addiction medicine or addiction psychiatry from the American Board of Addiction Medicine (ABAM) or the American Board of Medical Specialties (ABMS) or certifications by the American Osteopathic Academy of Addiction Medicine, ABAM or ASAM.
Dr. Morrone says that this is one of the fastest responses he has witnessed. “This is bigger than flu shots, bigger than pneumonia. More people die from drug overdose than from motor vehicle accidents or guns. This is stealing young people in their prime. We are losing mothers and fathers of small children. Additional prescribers and access to behavior health treatment is key in helping those individuals who struggle with opioid use disorder.”
The final rule will become effective on August 5, 2016.
At 5:13 ET April 12, 2016, the American Osteopathic Association (AOA) passed a resolution that will provide DOs who are ABAM diplomats with a process to attain an AOA subspecialty certification in Addiction Medicine.
Since 2002, when the AOA closed the clinical pathway to the addiction medicine subspecialty/CAQ, 390 osteopathic physicians sought and obtained an ABAM certification outside of the AOA. ABAM recently entered into an agreement under which its certification program will be administered by the American Board of Preventive Medicine (an American Board of Medical Specialties, ABMS board) and the new subspecialty of Addiction Medicine will be open to any physician certified by any of the 24 Member Boards of the ABMS. As a result, osteopathic physicians who have primary certification from AOA Certifying Boards are effectively shut out of the ABMS process.
The resolution calls for the AOA to create a mechanism to allow those osteopathic physicians who have an active AOA primary certification and an active ABAM certification to be granted subspecialty/CAQ certification in Addiction Medicine, with a requirement that they maintain such certification through the AOA’s Addiction Medicine Osteopathic Continuous Certification (OCC) process.
"For 30 years, securing a process for an Addiction Medicine CAQ has been promoted by the American Osteopathic Academy of Addiction Medicine(AOAAM). It has been a key part of our mission and couldn’t come at more critical time," said AOAAM President Dr. William Morrone. "With the exponential increase of substance misuse and addiction, expanding the expert workforce needed to wrestle the challenge is paramount. Every past president should be recognized for their dedication, perseverance and commitment in making this possible," said Dr. Morrone.
Members will receive more detailed information as it becomes available. AOAAM is hosting a small town hall session at the ASAM 2016 Annual Conference in Baltimore where AOAAM officials can provide more details about the ramifications of this milestone and answer questions.
AOAAM Online CME
OMED 2019 - October 24 -28Baltimore, MD
Waiver Eligibility Training
The mission of the American Osteopathic Academy of Addiction Medicine is
to improve the health of individuals and families burdened with the
disease of addiction.
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