Emergency Medicine Half and Half MAT Waiver Training-Module 6: Special Legal & Regulatory Considerations

Module 6: Special Legal & Regulatory Considerations

Pdf Summary

This document provides information on special legal and regulatory considerations for emergency physicians regarding the prescribing and administration of buprenorphine for opioid addiction. The document covers various topics and provides answers to key questions. <br /><br />The "DATA 2000 DEA X-waiver" refers to the Drug Addiction Treatment Act of 2000, which allows for the prescription of buprenorphine to treat opioid addiction outside of traditional treatment programs. To obtain an X-waiver, providers must have an active state medical license and a valid DEA license, and complete an eight-hour course (24 hours for PA/APRNs).<br /><br />The "72 Hour Rule" allows any licensed provider to administer a daily dose of buprenorphine to an ED patient for up to three days without an X-waiver. The dose and route of administration are not specified, but the patient cannot be dispensed a three-day supply. However, an X-waiver is required to prescribe buprenorphine or order doses to be dispensed from the ED for take-home use.<br /><br />Confidentiality regulations under 42 CFR Part 2, which protect the privacy of substance abuse treatment records, may make it more difficult to access records from opioid addiction treatment clinics. It is important for emergency physicians to obtain patient consent and follow specific rules when disclosing information related to substance abuse.<br /><br />DEA compliance is necessary for prescribing and dispensing/administering buprenorphine. Providers must adhere to regulations regarding patient limits, record-keeping, security, and prescription requirements. Violations of these regulations can lead to criminal penalties and loss of certification.<br /><br />Proper documentation is crucial when prescribing buprenorphine. Diagnosing the patient with "moderate" or "severe opioid use disorder" and documenting patient education and referral plans can expedite the referral process and improve patient outcomes.<br /><br />Clinics that provide methadone treatment are not required to report information to state prescription data monitoring programs (PDMPs) due to protection under 42 CFR Part 2. Methadone programs only administer and dispense methadone, not prescribe it.<br /><br />Overall, emergency physicians should consider obtaining an X-waiver to improve patient care and outcomes. Compliance with confidentiality regulations, proper documentation, and adherence to DEA requirements are essential for providing effective treatment for opioid addiction in the emergency department.

Keywords

special legal considerations

regulatory considerations

emergency physicians

buprenorphine

opioid addiction

DATA 2000 DEA X-waiver

72 Hour Rule

confidentiality regulations

DEA compliance

proper documentation