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Effort to train professionals about opioid prescribing will cut wide swath

August 24, 2011
by Gary A. Enos, Editor
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Addiction psychiatry group will launch its second clinical support system

A newly announced clinical support system to offer professional education on proper use of opioid medications will extend its reach well beyond prescribing physicians. Nurses and dentists also are among the groups that will be targeted in the Prescriber’s Clinical Support System, and the initiative’s medical director insists it is important to include addiction treatment experts in the discussion as well.

“Addiction professionals have a large role to play in this—a large number of people who use opioid medications will develop substance use disorders,” says Elinore McCance-Katz, MD, a professor of psychiatry at the University of California-San Francisco. “They can deliver the message that treatment is effective.”

McCance-Katz is medical director of this support system and a second that was launched in 2010 and focuses on the training of physicians to prescribe buprenorphine in office-based practice settings. Both projects came about as a result of federal Substance Abuse and Mental Health Services Administration (SAMHSA) grants awarded to the American Academy of Addiction Psychiatry (AAAP), an individual membership organization that also plays a significant role in the professional training of addiction-focused specialists.

SAMHSA this month announced that it had selected AAAP to receive a three-year, $1.5 million grant to develop the Prescriber’s Clinical Support System. The initiative will train health professionals in two distinct areas: the appropriate use of opioid therapies to treat opioid-related addiction, and the safe use of opioid medications to treat chronic pain. McCance-Katz believes it is important to cover both of these areas as part of an overall training effort.

“Prescribers really could do either; many work in both settings,” she says.

McCance-Katz emphasizes that the new clinical support system involves the participation of several partner organizations that also had been eligible to apply for the SAMHSA contract. Some of these groups are the American Medical Association (AMA), the American Psychiatric Association (APA) and the American Dental Association. Each of the partner organizations will be active in reaching out to its members. The American Society of Addiction Medicine (ASAM) is not participating directly in this specific project; it had worked on its own application for the SAMHSA contract.

McCance-Katz explains that the initiative will employ multiple means for reaching a significant number of professionals; she believes this is necessary given the “epidemic” levels of opioid misuse, abuse and dependence across the country.

“It’s extremely expensive to do face-to-face trainings,” she says. “We need to reach thousands of prescribers, not tens and hundreds.”

The initiative will develop a website with free training options. Webinars also will be a part of the overall effort, as will applications that can be used on smart phones. In addition, McCance-Katz says those who undergo training will have an opportunity to practice their skills online through a “virtual patient” program.

She believes there is a clear sense of urgency for getting clinical information out to prescribers. “I can’t say if the problem is worsening, because the current data we’re looking at is from 2009, but it certainly doesn’t look like it’s getting any better.”

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