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PA Role in Opioid Treatment Programs

Tuesday, December 12, 2017   (0 Comments)
Posted by: Janet Jordan
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Greetings PA Colleagues, 


I am contacting you to let you and the PAs in your constituent organization know about an AAPA resource that can help increase PA utilization in Opioid Treatment Programs (OTPs). 


Guidelines that govern OTPs are created by SAMHSA, the federal Substance Abuse and Mental Health Services Administration. OTPs are federally-regulated outpatient clinics where patients are treated with medication, most commonly methadone and suboxone, for opioid addiction. These have proven to be the gold-standard of the treatment of opioid addiction. 


The federal rules that guide the function of these clinics were updated in 2015, and at that time there was emphasis on the language in the rules the specify "physician only" regarding admitting and treating patients. 


Many PAs, including myself, have been working in the OTP settings for years, and there was great consternation about this restrictive federal interpretation. SAMHSA responded by creating a process by which OTPs can obtain an exemption, allowing PAs (and NPs) to fully function in such settings. 


Unfortunately, the exemption process is not well known, and is not frequently utilized. According to SAMHSA, clinics in just 12 states have requested the exemptions. Because of this, the AAPA has designed a resource for PAs and the OTPs where they work, outlining the exemption process and providing answers to common questions. 


The resource, titled "PA Role in Opioid Treatment Programs," is on the AAPA website, and can be seen at this link:


I am available as a resource to your leadership or members and would be glad to speak to either individuals or groups about this process. I should also note that this is a different issue than the new X-Waiver that allows PAs to prescribe suboxone in outpatient settings. OTP programs are a separate and unique entity, and this exemption process just applies to OTPs, and is not related to the DEA X-Waiver program. 


With the opioid epidemic having such deadly impact across the nation, now is a perfect time to enhance the utilization of PAs in the OTP/Medication-Assisted-Treatment effort. Lives are at stake, and PAs are ideally suited to be on the front lines of addressing this addiction epidemic.


Please contact me if I can provide additional information about how your PAs can use this AAPA resource to attain the ability to fully participate in this important effort. 




Jim Anderson, PA-C, MPAS, DFAAPA

President, AAPA Society for PAs in Addiction Medicine 

cell 206-371-9525

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