The number of lives lost to the U.S. drug-overdose epidemic hit a record high in 2020 and the number continues to trend upward, highlighting the importance of a recent collaboration between the AMA and the American Society of Addiction Medicine (ASAM) to expand access to life-saving medications.
The AMA, ASAM and the national nonprofit organization Shatterproof, have developed “Buprenorphine Mini-Course: Building on Federal Prescribing Guidance,” a free, one-hour education module designed to train medical professionals and students on prescribing buprenorphine for patients with opioid-use disorder (OUD).
The need for such a course could not be greater. The drug-overdose epidemic—which has been exacerbated by the COVID-19 pandemic—is believed to have taken the lives of 95,133 people in the U.S. for the 12-month period ending in February 2021, compared with 73,344 for the 12-month period ending February 2020, according to provisional data from the Centers for Disease Control and Prevention.
The latest figures from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) indicate that there are 107,905 waivered prescribers. Yet, patients continue to face numerous barriers to care, according to the “National Roadmap on State-Level Efforts to End the Nation’s Drug Overdose Epidemic,” (PDF) by the AMA and Manatt Health.
This includes delays and denials of care from health insurance companies and other payers, inadequate networks of addiction medicine and psychiatric physicians, and deep-seated stigma that causes patients to not seek treatment or get the support from families, friends or employers.
The new course builds on training provided by the SAMHSA quick start guide (PDF).
Opioid-use disorder a chronic condition
The course approaches OUD as a chronic condition and provides practical considerations for buprenorphine initiation, dosing and ongoing patient management to prescribers seeking to initiate buprenorphine for the treatment of opioid-use disorder.
Module faculty Yngvild K. Olsen, MD, MPH, medical director for the Institutes for Behavior Resources, Inc./REACH Health Services, and Melissa Weimer, DO, an associate professor of medicine and public health at the Yale School of Medicine, explore safe buprenorphine prescribing recommendations, guidance, and “nuts and bolts” for new prescribers.
Links to additional resources are provided, including the Recovery Research Institution’s “addiction-ary,” which provides a glossary of nonstigmatizing language.
“Stigma is real and strong and sometimes even extends to some of the treatments that we have to offer,” Dr. Olsen says in the module.
Celebrating the recovery journey
The course encourages clinicians to celebrate their patients’ progress and, appropriately enough, the module comes in time for the 32nd annual National Recovery Month, which celebrates OUD recovery “just as we would celebrate improvements made by those who are managing other health conditions such as hypertension, diabetes, asthma and heart disease.”
In that same spirit, and in addition to the instruction provided, both faculty members offer advice and encouragement for other physicians to provide care to patients with an OUD.
“It is just amazing to be able to actually provide a medication that is as safe and effective as buprenorphine for people who come in often at the end of their rope,” Dr. Olsen says. “We don't really have this effective medication for any other chronic illness.”
She adds that being a part of a patient’s journey from “sheer desperation” to recovery and reengagement with family and community “is incredibly satisfying and rewarding.”
Science, evidence and compassion must guide patient care and policy change as the nation's opioid epidemic evolves into a more dangerous and complicated illicit drug overdose epidemic. Learn more at the AMA's End the Epidemic website.
