DATA 2000 waiver training for medical students: Lessons learned from a medical school experience

Abstract

Background

In the midst of this national opioid crisis, it has become apparent that there is a large shortage in the workforce of treatment providers equipped to deliver evidence-based care for opioid use disorders (OUD). Medications for opioid use disorder (MOUD), such as buprenorphine, are crucial in reducing mortality in those with OUD, and yet prescribers must meet federal waiver requirements under the Drug Addiction Treatment Act of 2000 (DATA 2000). There are now several pathways for medical schools to satisfy these waiver requirements for all graduates, but this has not yet become widespread. We propose that including a DATA 2000 waiver training within the medical school curriculum is a feasible and effective way to meet eligibility requirements to prescribe buprenorphine. Methods: As part of a longitudinal opioid curriculum requirement, we implemented a DATA 2000 waiver training for all rising Year 4 medical students. One hundred sixty-nine students completed a hybrid (online and in-person) waiver training. The majority completed a pre- and post-survey. Results: The pre-training survey showed 93% of rising Year 4 medical students (112/120) reported participation in care of patients with OUD. Students six month post-training reported a rise in confidence (1.94 to 2.45; p < 0.01) and knowledge (2.27 to 2.76; p < 0.01) regarding MOUD. They also reported their plans to apply for the buprenorphine waiver once licensed and reported being more likely to prescribe buprenorphine for OUD as a result of the training (mean = 3.35; SD = 1.36; 0 = extremely unlikely to 5 = extremely likely). Conclusions: We successfully implemented a DATA 2000 waiver training as a mandatory requirement for the medical school curriculum. Further studies are needed to determine optimal timing, best format, and frequency of reinforcement of MOUD educational content across the undergraduate and graduate medical education continuum.

Keywords:

• Buprenorphine
• medical student
• medication-assisted treatment
• opioid use disorder
• curriculum
• waiver
• training

Acknowledgements

A special thank you to Jessica Perez from the Office of Education for managing the Qualtrics survey.

Author contributions

All authors participated in research conception and design. Sangeeta Lamba, Christin Traba, Bart K. Holland, Pravin Matthew, and Sophia Chen were responsible for data collection and analysis. All authors discussed interpretation of results and general themes of the manuscript. Erin Zerbo, Christin Traba, Sangeeta Lamba, Pravin Matthew and Bart K. Holland prepared the first draft of the manuscript. All authors provided significant edits and reviews.