Updated CDC Guidelines
The CDC updated their Clinical Practice Guideline for Prescribing Opioids for Pain. In response, the Oregon Medical Board updated the OMB's Statement of Philosophy on Pain Management.
DEA Removes Waiver Requirement to Prescribe Buprenorphine
On December 29, 2022, Congress signed the Consolidated Appropriations Act of 2023, thus removing the federal requirement for practitioners to submit a Notice of Intent (have a waiver) to prescribe medications, such as buprenorphine, for the treatment of opioid use disorder (OUD).
All DEA registrants should be aware of the following:
- A DATA-Waiver registration is no longer required to treat patients with buprenorphine for opioid use disorder.
- Going forward, all prescriptions for buprenorphine only require a standard DEA registration number. The previously used DATA-Waiver registration numbers are no longer needed for any prescription.
- There are no longer any limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine.
- The Act does not impact existing state laws or regulations that may be applicable.
The Consolidated Appropriations Act also introduced new training requirements for all prescribers. Section 1263 requires new or renewing DEA registrants, starting June 27, 2023, to have at least one of the following:
- A total of eight hours of training from certain organizations on opioid or other substance use disorders for practitioners renewing or newly applying for a registration from the DEA to prescribe any Schedule II-V controlled medications;
- Board certification in addiction medicine or addiction psychiatry from the American Board of Medical Specialties, American Board of Addiction Medicine, or the American Osteopathic Association; or
- Graduation within five years and status in good standing from medical, advanced practice nursing, or physician assistant school in the United States that included successful completion of an opioid or other substance use disorder curriculum of at least eight hours.
Visit SAMHSA.gov or DEAdiversion.usdoj.gov, or see the DEA’s Training Requirements document to learn more.
Pain Management Required Course and Updated Resources
All Oregon Medical Board licensees must complete the Oregon Pain Management Commission's (OPMC) continuing education course at initial licensure and every two years . The course now includes topics such as health equity. See the Continuing Education page for details.
Additionally, a workgroup comprised of representatives of the OPMC, Oregon Health Authority (OHA) Public Health, and Providence Health & Safety, as well as six clinical experts, have developed the Pain Education Toolkit, which offers patient and provider educational resources on topics such as sleep, nutrition, and medications.
Visit OregonPainGuidance.org/paineducationtoolkit to access the toolkit. A clinician-focused version is also available at OregonPainGuidance.org/paineducationtoolkitforclinicians.
Prescription Drug Monitoring Program (PDMP)
All Oregon-licensed physicians and PAs who have a DEA number are required to register for the PDMP. Register at oregon.pmpaware.net by selecting "Create an Account." For more information, please review OAR 847-010-0120 and OAR 333-023-0825. For questions, contact the PDMP at 866-205-1222 or pdmp.health@state.or.us.
The Oregon Health Authority adopted rules to align with requirements in 42 U.S.C. 1396w-3a. The rules require Oregon Health Plan (OHP) enrolled providers and Coordinated Care Organization (CCO) contracted providers to check the PDMP before prescribing controlled substances to covered individuals. See OAR 410-120-1260(13) and OAR 410-141-3855(15) for details.
In July 2020, the Food and Drug Administration provided guidance directing health care professionals to discuss naloxone, a potentially life-saving medication that can reverse drug overdoses, with all patients when prescribing opioid pain relievers or medicines to treat opioid use disorder. See the FDA's website for additional information.