FAQ Breaks Down New Controlled Substance Rx Rules for FPs
April 12, 2023, News Staff — A new resource from the AAFP explains what family physicians need to know about recently updated guidance on training for prescribing controlled substances.
“New Training Requirement for Controlled Substance Rx: Answers to Common Questions” helps family physicians who prescribe controlled substances in schedules II, III, IV, and V ensure fulfillment of required one-time, eight-hour training prior to their first DEA registration or next DEA license renewal. The training requirement goes into effect June 27, but physicians have until they renew or obtain their DEA license to complete any additional training hours.
The member resource notes that the DEA is allowing physicians to attest that they have fulfilled training required by the Medication Access and Training Expansion Act without submitting detailed paperwork — a victory for the AAFP’s advocacy. In addition, both the DEA and the Substance Abuse and Mental Health Services Administration have updated curricular recommendations to confirm that previous X-waiver and other substance use disorder training hours will count toward the new requirements when completed with an accredited organization, including the AAFP. These wins resulted directly from the Academy’s recent letter to the DEA and SAMHSA with detailed recommendations on how best to implement the MATE Act.
DEA-licensed physicians will not need to attest to completing the training requirement until their existing license is up for renewal. Current residents and anyone who completed residency in the last five years will need to attest only that they are a recent graduate whose training included eight hours of SUD and/or safe-prescribing training.
Protecting Patient Access
With related prescriber rulemaking still underway, the AAFP recently responded to a proposed rule on telehealth prescribing of schedule III-V non-narcotic medications to patients who haven’t had an in-person medical evaluation, as well as to a rule that would make a prescribing exception for buprenorphine, a schedule III narcotic, for the treatment of opioid use disorder.
The AAFP’s guidance pointed out opportunities to limit administrative complexity for physicians while ensuring that patients can access lifesaving care for opioid use disorder.
Naloxone Update
The AAFP welcomed another recent regulatory update: the FDA’s approval of 4 mg naloxone hydrochloride nasal spray for over-the-counter, nonprescription use, in line with Academy policy.
The change will not immediately require family physicians to alter their prescriptions, and the Academy is advocating for a regulatory transition from prescription to OTC naloxone use that won’t create cost barriers or limit access.
The AAFP has long supported policies that make naloxone available to patients who use opioids and individuals in close contact with those patients, including personnel at safe injection sites, first responders and non-medical personnel. The Academy’s "Treating Opioid Use Disorder as a Chronic Condition: A Practice Manual for Family Physicians" remains available for free download to all AAFP members.