A Generation Ready for Change: Preparing for the Deregulation of Medications for Opioid Use Disorder in Undergraduate Medical Education

Abstract

The U.S. Department of Health and Human Services recently released updated guidance that allows providers under standard licensure to treat 30 or fewer patients with buprenorphine, a partial opioid agonist shown to be safe and effective as an office-based treatment for opioid use disorder (OUD). Previously, physicians and advanced practice providers needed to complete specialized training and certification under the Drug Addiction Treatment Act (DATA) of 2000 before prescribing medications for OUD (MOUD). This deregulatory action comes as rates of opioid-involved overdose have accelerated during the COVID-19 pandemic. Given the limited success of stepwise efforts to legislate for expanded access to MOUD, providers, professional associations, and other advocates have called for the elimination of the DATA requirements for all practitioners. An understanding of the statutory and regulatory history of MOUD may prove critical as legislative and policy actions continue to reshape clinical practice. Incorporating MOUD training as a standard in undergraduate medical education represents a unique opportunity for the medical community to prepare trainees for future deregulation of MOUD. Indeed, medical schools already offering or requiring MOUD training have demonstrated success in improving MOUD knowledge, skills, and attitudes among medical students and graduates. Existing virtual and hybrid training tools designed to meet DATA standards represent an accessible means to ensure critical learning for future generations of physicians uniquely ready and willing and to provide quality, evidence-based care to patients with OUD.