Medication-Assisted Treatment Trainings Offered Across North Carolina
In 2017, North Carolina’s drug overdose death rate rose higher than any other state except for Indiana, primarily due to opioids, with more than five North Carolinians dying every day from an unintentional opioid overdose.
To address this public health crisis, the World Health Organization, the National Institutes of Health, the Centers for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the American Society of Addiction Medicine all recommend prescribing medication-assisted treatment (MAT) for patients with opioid use disorders (OUD) “given the strong evidence of effectiveness for such treatments.”
MAT includes FDA-approved medications such as methadone, which can only be dispensed by a certified opioid treatment program, naltrexone, and buprenorphine, which can be prescribed in outpatient primary care practices. Individuals with opioid use disorder who receive MAT are approximately 60 percent more likely to remain in treatment and free of illicit opioids at 12 months, which is significantly better than abstinence-only approaches.
Despite its proven efficacy, less than 10 percent of physicians in the United States have waivers to prescribe buprenorphine, many of whom are psychiatrists and addiction specialists located in urban areas. Research has found that individuals with opioid use disorder are more willing to enter primary care settings than specialty treatment centers, suggesting a growing need for primary care providers to prescribe buprenorphine, especially those practicing in rural areas.
To address this critical need, the NC Department of Health and Human Services (DHHS) has contracted with the Mountain Area Health Education Center (MAHEC) in Asheville to provide MAT waiver training to medical residency programs across the state through August 31, 2019. This work is being funded through NC DHHS’s award from the CDC’s Cooperative Agreement for Emergency Response: Public Health Crisis Response – Opioids.
After successfully completing this 8- or 24-hour training, residents will be able to prescribe buprenorphine to treat patients with OUD. MAHEC will also help North Carolina residency programs incorporate MAT training into their curricula.
“We will identify faculty champions in each program and ‘train the trainer’ to ensure future residents are able to provide MAT,” explained Dr. Blake Fagan, chief education officer at MAHEC, family physician, and buprenorphine prescriber.
While training the next generation of providers is crucial, it is not enough to address the growing crisis.
“Only 11 percent of individuals with an opioid use disorder are able to find a provider who can help them,” Fagan shared. “We need to train as many current primary care providers as we can to meet this overwhelming need.”
The statewide push to train residents in MAT creates another workforce need. The vast majority of primary care providers have not participated in MAT waiver training and, as a result, are unprepared to adequately supervise and support North Carolina’s next generation of health care providers who are eager to address this crisis and will have buprenorphine waivers.
With financial support from the North Carolina Medical Society, NC AHECs across the state are offering MAT trainings to ensure primary care providers can address the opioid epidemic in their own communities and are ready to supervise and support the physicians, physician assistants, and nurse practitioners who will join their practices in the years to come. NC AHEC offerings include team-based MAT training to ensure clinical care teams can support prescribers in successfully delivering office-based opioid treatment.
North Carolina providers can access free ongoing technical assistance and mentorship for MAT through UNC Chapel Hill’s online Project ECHO for MAT, SAMHSA’s State Targeted Response Technical Assistance Consortium, and the Providers Clinical Support System.
View Office-Based Opioid Treatment training options across the state. For more information about MAT trainings in your region, contact your local AHEC.