Opioid Use Disorder

The ACGME believes that physicians should have equal access to all of the resources and training they need to effectively treat Opioid Use Disorder (OUD), including behavioral techniques and medication-based therapy. The need to educate physicians on the treatment of addiction, for this and the next generation, is a shared responsibility of the medical school, graduate medical education (GME), and continuing medical education communities.

ACGME Common Program Requirements

Effective July 1, 2019, the ACGME requires that all programs “provide instruction and experience in pain management if applicable for the specialty including recognition of the signs of addiction.” (Common Program Requirement IV.C.2.)

This requirement directs appropriate residency and fellowship programs to develop evidence-based educational interventions to effectively teach residents and fellows how to:

    • Prevent addiction wherever possible while effectively treating pain;
    • Recognize addiction in its earliest stages;
    • Function effectively in systems of care for effective pain relief and addiction;
    • Use non-pharmacologic means wherever possible; and,
    • Participate in clinical trials of new non-opioid pain relief customized to the needs of the clinical disorders of the populations they serve.

Resources for Pain Management and Addiction

The following resources can be used to help programs and institutions identify solutions to meet local needs. The ACGME does not endorse the use of any specific tool or resource.

New England Journal of Medicine Knowledge + Pain Management and Opioids module

The New England Journal of Medicine, in partnership with Boston University School of Medicine’s SCOPE of Pain and Area9 Lyceum, has instated a new learning module to assist in furthering education regarding pain management, opioid prescribing, and OUD. The NEJM Knowledge + Pain Management and Opioids module was made available by an educational grant from the Opioid Analgesic Risk Evaluation and Mitigation (REM) Strategies Program Companies.

Medication Assisted Treatment (MAT) Waiver Training

MAT of substance use disorders involves a combination of medications that target the brain, and psychosocial interventions (e.g., counseling, skills development) aimed at improving treatment outcomes. Research shows that medications and therapy together may be more successful than either treatment method alone.
This course will allow users to:

    • Review addiction identification and evidence-based treatments.
    • Discuss the pharmacology of opioids as it relates to treatment of OUD patients.
    • Describe the fundamentals of office-based opioid treatment, including the treatment of the co-morbid patient.
    • Explain the process of buprenorphine induction, as well as stabilization and maintenance.
    • Discuss other approved antagonist and agonist medications to treat OUD.
    • Discuss basic office protocols, including medical record documentation and confidentially.
    • Utilize evidence-based resources to ensure providers have the confidence to prescribe buprenorphine for patients with OUD.

National Academy of Medicine (NAM) Action Collaborative on Countering the US Opioid Epidemic

The ACGME participates in and supports the NAM Action Collaborative on Countering the US Opioid Epidemic. ACGME President and CEO Thomas J. Nasca, MD, MACP is a member of the Steering Committee and co-chairs the Health Professional  Education and Training Working Group. The Working Group is currently identifying and highlighting professional practice gaps for health care professionals in relation to acute and chronic pain management and substance use disorders, as well as analyzing current accreditation, certification, and regulatory requirements for the same.

Centers for Disease Control (CDC) Guideline for Prescribing Opioids for Chronic Pain

Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse or overdose from these drugs.

The CDC developed and published the CDC Guideline for Prescribing Opioids for Chronic Pain to provide recommendations for the prescribing of opioid pain medication for patients 18 and older in primary care settings. Recommendations focus on the use of opioids in treating chronic pain outside of active cancer treatment, palliative care, and end-of-life care.

For more information, contact Chief Communications and Public Policy Officer Dr. John Combes: jcombes@acgme.org.