APA Offers Online Course In Buprenorphine Treatment

A new Internet training course offered by APA has the potential to improve treatment for thousands of people struggling with opiate addiction.

The interactive eight-hour course, “Buprenorphine for Office-Based Treatment of Opiate-Dependent Patients,” is an addition to APA’s CME Online Program and teaches psychiatrists what they need to know about treating opiate-addicted patients with buprenorphine.

The online course was launched at the end of April and can be accessed through APA’s Web site at www.psych.org. The course fee is $100 for APA members and $200 for nonmembers. Those who complete the course are eligible to receive eight hours of CME credit.

The course will make learning about buprenorphine treatment much more convenient for physicians. Previously, psychiatrists who wanted to take the course through APA had to travel to one of its meetings. APA has offered this live training twice before—at the 2001 annual meeting in New Orleans and the 2001 Institute on Psychiatric Services in Orlando. The training will also be offered at APA’s 2002 annual meeting in Philadelphia on Wednesday, May 22.

APA’s CME Online Program also features a four-hour Internet “refresher” course for psychiatrists who have already taken the longer course and would like to review the course content.

The Internet training course consists of seven parts. There are three slide presentations with accompanying audio lectures that train physicians about basic and applied pharmacology, assessment of patients with medical comorbidities and other special treatment populations, and clinical management and dosing. Each lecture is followed by test questions that link into the relevant text for immediate feedback on answers.

Three case studies are presented that demonstrate the selection of the appropriate level of care for opiate-addicted patients; explain the treatment of patients with medical comorbidities; and discuss diagnosis, treatment, and confidentiality issues. Questions are interspersed throughout the case studies.

The last part of the course consists of an “update” section, which includes additional information such as the government regulations to which physicians must adhere to prescribe buprenorphine in their offices. It also includes sample questions and answers about the office-based treatment.

One feature of the online course physicians will find helpful is that it doesn’t have to be completed in one sitting. When they log back on after ending a session, they will find that the program has kept track of the course material completed, making it easy to resume where they left off.

Buprenorphine is a partial opiate agonist that has been found in clinical trials to be more effective than methadone for the reduction of opiate abuse. It has been shown to be safer and have less potential for abuse, especially in combination with naloxone (Psychiatric News, September 1, 2000). It is also a mild narcotic, so there are government restrictions on the use of the drug.

APA is one of five organizations designated by the U.S. Department of Health and Human Services (HHS) to provide physician training in the use of buprenorphine for treatment of patients who are addicted to opiates.

The eight-hour course meets the federal training requirement that enables physicians to qualify for the waiver they need to dispense the medication in their offices. When applying for a waiver to prescribe or dispense narcotic drugs, physicians must submit a notification of intent to HHS or the Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment (CSAT). This procedure was mandated by the Drug Addiction Treatment Act of 2000.

However, those who are already board certified in addiction psychiatry need not take the buprenorphine course to apply for the waiver.

Thomas Kosten, M.D., a professor of psychiatry at Yale University School of Medicine, has worked extensively with CSAT to develop the curriculum for training sessions held around the country. He also led the development of the Web-based course.

“All physicians will benefit from this online course so that they are better prepared to treat patients with addictions in office-based settings,” he said. Doctors’ offices, he noted, are more confidential settings than government-run methadone clinics, for instance, where most people are currently treated for opiate addiction.

At present, there is one major obstacle to physicians prescribing buprenorphine in their offices: The Food and Drug Administration has yet to approve the drug’s use for this purpose. Until this happens, physicians cannot prescribe the drug for opiate addiction. While this approval has been imminent for many months, the FDA is now expected to approve the drug for this use by this summer.

The online course can be accessed at APA’s Web site at www.psych.org by clicking on “Online CME Programs.” Members must enter their APA identification number and password to access the course; nonmembers will be asked to register on the site. More information about the course can be obtained by contacting Kristen Moeller by phone at (202) 682-6109 or by e-mail at [email protected]. ▪