Consolidated Appropriations Act of 2023

Medication Assistant Treatment Education (MATE) Mandate
Information for Family Physicians

On December 29, 2022, the Consolidated Appropriations Act of 2023 enacted a new one-time, eight-hour training requirement for all Drug Enforcement Administration (DEA)-registered practitioners on the treatment and management of patients with opioid or other substance use disorders.

This is a one-time requirement. Once you’ve attested to completing this training, you will not be required to complete any additional training under current law. The DEA will not require you to attest to this training after your first attestation.

Who does this impact?

  • All DEA-registered practitioners, with the exception of practitioners that are solely veterinarians.

How will practitioners be asked to report satisfying this new training requirement?

  • Beginning on June 27, 2023, practitioners will be required to check a box on their online DEA registration form—regardless of whether a registrant is completing their initial registration application or renewing their registration—affirming that they have completed the new training.

What is the deadline for satisfying this new training requirement?

  • The deadline for satisfying this new training requirement is the date of a practitioner’s next scheduled DEA registration submission—regardless of whether it is an initial registration or a renewal registration—on or after June 27, 2023.
  • This one-time training requirement affirmation will not be a part of future registration renewals.

Please Note:

Controlled substances prescribers in Utah are still required to complete a one-time 3-hour Screening, Brief Intervention, and Referral to Treatment (SBIRT) training before January 31, 2024. SBIRT training can be used toward the 8-hour MATE requirement.

Do I need to complete this training?

If you finished your residency program more than five years ago and are a prescriber of schedules II through V medications, you’ll need to attest that you’ve completed this training when you obtain or renew your DEA license. A few key points about training:

  1. The training does not have to occur in one session. It can be cumulative across multiple sessions that equal eight hours of past trainings on the treatment and management of patients with opioid or other substance use disorders can count towards a practitioner meeting this requirement. In other words, if you received a relevant training from one of the groups listed below— prior to the enactment of this new training obligation on December 29, 2022—that training counts towards the eight-hour training requirement.
  2. Past DATA-Waived trainings count towards a DEA registrant’s 8-hour training requirement.
  3. Trainings can occur in a variety of formats, including classroom settings, seminars at professional society meetings, or virtual

What if I’m a recent graduate?

If you graduated from medical school within the five years immediately preceding June 27, 2023, and received at least eight hours of training related to SUD and safe prescribing for pain while in school or residency, you do not need to complete additional training. When you obtain or renew your DEA license, there will be a box to check that indicates you graduated within the previous five years and therefore have satisfied the new training requirement.

The DEA is not requesting documentation related to medical school or residency training to comply with this law. However, saving course overviews or specific hours of classes and training related to SUD screening, treatment, or safe prescribing will ensure that you have documentation on hand should you ever need it during a DEA audit for other purposes.

What if I’m about to graduate or am still in medical school?

The five-year timeframe for recent graduates is rolling—for example, if you plan to graduate, complete residency and obtain your DEA license in 2025, you will still be able to check a box that indicates you graduated within the past five years and received this training as part of your education.

I thought the X-waiver to prescribe buprenorphine was removed. Is this the same thing?

The X-waiver (also known as the DATA 2000 waiver) is no longer required to prescribe buprenorphine for opioid use disorder. While the X-waiver requirement was removed by the Consolidated Appropriations Act of 2023, it is separate and unique from this new training requirement.

The X-waiver required eight hours of training on OUD screening, treatment, and buprenorphine prescribing each time a practitioner’s waiver was renewed. This is no longer required, and clinicians can prescribe buprenorphine for OUD without a federal X-waiver, when otherwise compliant with applicable federal and state laws.

The new training requirement is related to all substance use disorders and safe prescribing, not just OUD and buprenorphine. It is required for all clinicians who prescribe schedules II-V medications. As noted above, unlike the X-waiver, the MATE Act training is a one-time training—once you obtain or renew your DEA license and attest to completing this training, you don’t need to complete more training for subsequent renewals unless your state requires it.

What accredited groups may provide trainings that meet this new requirement?

  • The American Society of Addiction Medicine (ASAM)
  • The American Academy of Addiction Psychiatry (AAAP)
  • American Medical Association (AMA)
  • The American Osteopathic Association (AOA), or any organizations accredited by the AOA to provide continuing medical education
  • The American Dental Association (ADA)
  • The American Association of Oral and Maxillofacial Surgeons (AAOMS)
  • The American Psychiatric Association (APA)
  • The American Association of Nurse Practitioners (AANP)
  • The American Academy of Physician Associates (AAPA)
  • The American Nurses Credentialing Center (ANCC)
  • Any other organization accredited by the Accreditation Council for Continuing Medical Education (AACCME) or the Commission for Continuing Education Provider Recognition (CCEPR), whether directly or through an organization accredited by a State medical society that is recognized by the ACCME or CCEPR
  • Any other organization approved or accredited by the Assistant Secretary for Mental Health and Substance Use, the ACCME, or the CCEPR

Please note: Activities with solely AAFP Prescribed or Elective credit do not yet count. The AAFP is communicating with SAMHSA to address this oversight.

Eligible Trainings (current as of 5/22/23)

The following list is not exhaustive and UAFP advises that you verify the accreditation of each course to ensure it meets the requirements for eligible training.

AAFP: Substance Use Disorders

Substance Education Institute: 2021-2022 Opioid Education for Utah Licensed Practitioners

NEJM: Pain Management and Opioids

UMA 2023 Controlled Substances: Education for the Prescriber

InforMed CME: Utah CME for Physicians 

Substance Education Institute: Screening, Brief Intervention, and Referral to Treatment (SBIRT) designed by University of Utah Faculty

AMA: Understanding Pain and Conducting a Pain Assessment: Practical Guidance for Pain Management 1.5 Credits FREE

AMA: Using Opioids Safely: Practical Guidance for Pain Management 2.5 Credits FREE

AMA STEPS Forward: Essentials of Good Pain Care: A Team-Based Approach 0.5 Credit FREE

American Society of Addiction Medicine Education: Buprenorphine Mini-Course: Building on Federal Prescribing Guidance 1 Credit FREE

American Society of Addiction Medicine Education: Association of Dose Tapering With Overdose or Mental Health Crisis Among Patients Prescribed Long-term Opioids 1 Credit

JAMA: Contingency Management for Patients Receiving Medication for Opioid Use Disorder 1 Credit

JAMA Psychiatry: Receipt of Telehealth Services, Receipt and Retention of Medications for Opioid Use Disorder, and Medically Treated Overdose Among Medicare Beneficiaries Before and During the COVID-19 Pandemic 1 Credit

JAMA Psychiatry: The ASAM Criteria Online Foundations Course 8 Credits

UpToDate articles that satisfy the DEA requirement for substance use training - 8 hours required - each article will earn 0.5 hours of CME

For information regarding the DEA Diversion Control Division, please visit www.DEAdiversion.usdoj.gov. If you have any additional questions on this issue, please contact the Diversion Control Division Policy Section at (571) 362-3260.

Additional Resources:

Letter from Utah Department of Commerce Division of Professional Licensing

U.S. Department of Justice Drug Enforcement Administration - Letter for DEA Registered-Practitioners 


Resources:

The above information was obtained from the U.S. Department of Justice (DOJ), Utah Department of Professional Licensing (DOPL), American Academy of Family Physicians (AAFP), Thomas Miller, CMO with University of Utah Health, and Hailey Ritchie, General Counsel with University of Utah Health.

Please contact UAFP if you have any questions or corrections.