New DEA training requirement: who has to do it, and how to get it done

The Drug Enforcement Administration (DEA) recently started requiring a new eight-hour training aimed at preventing substance use disorder. Here’s a guide to who must complete it and how to get it done.

WHO: The new training requirement applies to almost all clinicians who prescribe controlled substances under a DEA registration, as well as those who are seeking a DEA registration to begin prescribing controlled substances.

Here’s a list of who is exempt:

• Anyone who has previously completed the eight-hour buprenorphine “X waiver” training (if you got an X waiver without completing the training, that does not count and you will have to complete eight hours of training to comply with the new requirements),
• Anyone who is board certified in addiction medicine or addiction psychiatry,
• Anyone who graduated in good standing within the past five years from a U.S. medical school, advanced practice nursing school, or physician assistant school or residency program whose graduation requirements include a minimum of eight hours of opioid and other substance use disorder curriculum. (Many schools and programs meet this standard, but if in doubt confirm with your program.)

WHAT: The new DEA training requirements call for a total of eight hours of CME on the prevention and treatment of opioid use disorder and other substance use disorders. The training does not have to be completed all at once and doesn’t have to be entirely focused on opioid use disorders. It does have to include training on all Food and Drug Administration-approved medications for treating substance use disorders (approved medications are currently available for alcohol, nicotine, and opioid use disorders). For more information, see this American Academy of Family Physicians (AAFP) page.

WHERE: Free, online, asynchronous training is available from the federally funded Providers Clinical Support System. The AAFP offers training that fulfills the requirement and is free to members. The American Medical Association also provides training resources, though not all are free.

WHEN: The new requirement took effect June 27. The next time you renew your DEA registration (or apply for one for the first time), you will be required to attest to having fulfilled the eight-hour training requirement or being part of the exempt groups listed above. If you have a current DEA registration, you can continue to prescribe controlled substances without meeting the training requirement until your next renewal. That means those who renewed shortly before the requirements took effect will have until 2026 to complete the training. Once you’ve attested to meeting the eight-hour training requirement, you will not have to complete additional training or re-attest in the future.

WHY: The new training requirement is a result of Congress passing a budget bill that included the Mainstreaming Addiction Treatment (MAT) and Medication Access and Training Expansion (MATE) Acts. The acts are meant to address the nation's opioid use disorder crisis and rising overdose deaths by expanding the number of clinicians who are trained in the use of buprenorphine and able to prescribe it. The MAT Act took effect at the end of 2022, eliminating the X waiver that was previously required to prescribe buprenorphine for opioid use disorder in the outpatient setting and allowing any clinician who holds a standard DEA registration to provide the life-saving treatment in their practice immediately. The MATE Act replaced the previous X waiver program with the new training requirement that is meant to ensure all clinicians who can prescribe controlled substances have a basic understanding of evidence-based substance use disorder prevention and treatment.

— Alicia A. Kowalchuk, DO, FASAM

Posted on July 5, 2023, by FPM Editors