House of Representatives member Representative Susan W. Brooks recently introduced the ADAPT Act of 2018. The ADAPT Act (Abuse Deterrent and Prescriber Training Act of 2018) is an attempt to require training for prescribers of controlled substances.
The bill would amend the Controlled Substances Act to include a requirement for all practitioners who are licensed under State law to prescribe controlled substances in Schedule II, III, IV, or V, a written certification that the practitioner has completed 3 hours of training under a specific training program, in all registration or renewal requests.
The training program will meet the requirements only if it includes information on the following:
- safe opioid prescribing guidelines, including the Guideline for Prescribing Opioids for Chronic Pain issued by the Centers for Disease Control and Prevention;
- the risks of opioid medications and other prescription drugs that are controlled substances;
- pain management, including the need to provide individualized care particularly for active cancer treatment, palliative care, and end-of-life care;
- early detection of opioid and other substance use disorders;
- the risks of prescribing opioids to any individual in recovery from a substance use disorder;
- a basic understanding of addiction;
- the treatment of opioid-dependent patients and their treatment options;
- the risks of misuse of all prescription drugs that are controlled substances; and
- alternative non-opioid pain management medications and other effective treatments;
The legislation also assigns the Secretary of Health and Human Services to develop a model training program on prescribing opioids to be used for the purpose of educating prescribers on abuse deterrents with respect to opioids.
All qualifying CME programs must be approved by the State agency with the primary responsibility for licensing the practitioner to prescribe controlled substances. If states do not have in effect an approval of any training program, the program must conform to a model training program, which is to be determined.
Interestingly, the legislation currently carries the requirement of a report to Congress to be submitted two years after the date of the enactment of the Act. The report to Congress will be an overview of the effects of the Act and any amendments, including an analysis of the following: whether there has been a reduction in the volume of opioids prescribed; whether there has been an increase in the likelihood that opioid-dependent patients receive substance use disorder treatment; whether there has been a reduction in opioid-related overdoses and deaths; whether training required by this Act and the amendments made by this Act has changed prescribing practices and increased patient referrals to treatment; and the extent to which prescribers have conformed their practices to those recommended in training pursuant to this Act and the amendments made by this Act.
The legislation has been referred to the Committee on Energy and Commerce and the Committee on the Judiciary. No further actions are scheduled at this time, but we will certainly be keeping an eye on this bill as it will have ramifications for the CME community if passed.