Unique medical school program trains students to qualify to treat addiction

More than 30 fourth-year medical students at the Warren Alpert Medical School will gain the training required to prescribe medication-assisted therapy for opioid use disorder under a first-in-the-nation program implemented in partnership with the state of Rhode Island.

PROVIDENCE, R.I. [Brown University] — In the first program of its kind in the country, more than 30 members of the Class of 2018 at the Warren Alpert Medical School of Brown University will receive the training necessary to prescribe FDA-approved medications for the treatment of opioid use disorders.

The Drug Abuse Treatment Act of 2000 (DATA 2000) requires physicians to obtain a waiver to prescribe the medications. With the training they receive while in medical school, the students will be able to apply for the waiver once they graduate, receive their full medical license and their Drug Enforcement Administration registration.

The state of Rhode Island and the school created the program, outlined in a recent report in the American Journal on Addictions, to increase the number of DATA 2000 waivered physicians who could gain additional experience in treating substance use disorders during residency and provide the access to clinical care. Training for the DATA 2000 waiver typically is not available to doctors until they are practicing.

In future years, the program will extend to the entire medical school class.

“Not only does the DATA waiver program allow Alpert Medical School students to graduate having met the educational requirements for office-based treatment of opioid use disorder, but it also helps to bring treatment of substance use disorders into mainstream medicine and helps the students develop a greater sense of confidence in their ability to treat the disorder,” said Dr. Elinore McCance-Katz, chief medical officer at the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH), a Brown University professor of medicine and public health, and co-creator of the DATA 2000 waiver program.

“All graduating medical students will have received 23 hours of substance use disorders training, which is far in excess of the eight hours required to obtain the DATA 2000 waiver. We are pleased to lead the way with Brown University on this innovative approach to the national overdose epidemic.”

The program is part of Rhode Island Gov. Gina Raimondo’s Overdose Prevention and Intervention Task Force’s action plan, which has four components: Treatment, Rescue, Prevention and Recovery. The DATA waiver training is part of the treatment component.

The mechanism for DATA waiver qualification applies only to physicians practicing in Rhode Island, but the Rhode Island Department of Health will reach out to other states to encourage them to consider partnering with medical schools in their states to certify addiction medicine curricula that would qualify for a DATA waiver, too.

Dr. Paul George, assistant dean for medical education at the Alpert Medical School, said training students in this way is important in addressing the opioid epidemic.

“Hospitals and health care facilities are being overwhelmed by individuals who are seeking treatment for opioid use disorders, and they cannot meet the demand,” he said. “This program is a significant step forward in increasing the number of physicians who can prescribe medications to treat opioid use disorders. My hope is that other medical schools will partner with their state governments to develop similar programs.”

The program complements other efforts at the medical school to prepare students to care for people with opioid use disorders.  In 2015, for example, the school received a federal grant to train students to perform addiction screening.

Making addiction medicine a standard part of medical school curriculum may contribute to reducing the stigma around substance use disorders, health care experts say. As the single state authority for substance abuse for Rhode Island, BHDDH has a goal to waiver train more than 400 physicians by 2018.