Opioid dependence is a major public health problem in the U.S. and access to effective treatments is limited. The principal barrier to receiving care in office-based settings is largely the insufficient number of physicians providing office-based treatment. The lack of physicians willing to provide office-based treatment of opioid dependence with buprenorphine is partially a result of the low number of trained physicians who apply for and use their waivers to treat opioid dependence. There are an estimated 800,000 licensed U.S. physicians in the United States. Among these, approximately 470,000 provide general ambulatory care and 42,000 provide specialty psychiatric care. Therefore, the 15,000 who have received training and the 12,000 with the appropriate waiver represent a very small minority of the potential physicians who could provide these important services. In addition to the low number of potential physicians who have sought training, there are relatively low proportions of physicians who have completed the training and have gone on to seek the special DEA registration. Additionally, once these registrations are received many physicians have elected not to treat patients with buprenorphine in their offices. ASAM proposes to develop and convene an educational program addressing the use of buprenorphine in clinical practice to target physicians, addiction and other health care professionals. This proposed program is designed to reinforce, expand, and clarify information presented in the basic education program, "Buprenorphine and Office-based Treatment of Opioid Dependence," which was developed to meet the requirements of DATA 2000. As a result of attendance at this program, these physicians unwilling to treat a patient with opioid dependence will change their current practice and use this medication. Participants in the basic education program have identified a number of educational needs and barriers not covered by that program. The primary goals of this program are designed to address these needs and barriers, to improve practitioner's skills and confidence in the provision of office-based opioid treatment (OBOT). Ultimately, it is ASAM's desire to improve patient access to treatment for opioid dependence.
There is a public health crisis in the US due to the high rates of opioid dependence, and the lack of physicians who are able to effectively treat opioid dependence. Specifically, there are a significant number of physicians who have taken the required 8-hour "Buprenorphine and Office-Based Treatment of Opioid Dependence" course, but are not utilizing this important treatment strategy. This program aims to target under-served and rural areas for opioid dependence with advanced clinical education for waivered and non-prescribing physicians.