Opioid Continuing Medical Education Requirements

In December 2022, Congress enacted a requirement for US Drug Enforcement Administration (DEA)-registered practitioners to complete 8 hours of training on opioid or other substance use disorders. That’s right, there is a new requirement for 8 hours of controlled substances continuing medical education (CME) to maintain DEA certification to pre- scribe opioids.

As a general medical dermatologist who performs little surgery, I rarely prescribe opioids or other controlled substances. It would be easier for me to give up my DEA certification to prescribe opioids than do 8 hours of CME to maintain the certification. But “damn it, Jim, I’m a doctor.*” I feel an obligation to complete the requirement, even though this is a skill I will rarely, if ever, use. For those of you who are looking for CME to complete the opioid training requirement, our publisher, HMP Global, now has MATE Act training available. Visit https://www.hmpglobalevents.com/matetraining for more information.

I am sure this new government mandate is well meaning, and I am confident the purpose of the mandate is to help stem the opioid crisis in the United States. However, I doubt this 8-hour CME requirement will have a detectable beneficial effect on the crisis. In fact, I doubt the government will even try to measure whether the mandate has any beneficial effect. At best, I suspect this requirement will cause some physicians—those who, like me, rarely prescribe any controlled substances—to give up their controlled substances prescribing privileges.

Passing feel-good laws that add hassle to our professional lives and no meaningful benefit is a first-world scourge. If there are half a million health care providers in the United States and half of them have controlled substances prescribing privileges, the new opioid CME requirement will cost 2 million hours of their time. This is time spent that may have little relevance to the care health care providers give their patients.

We should be mindful of costs. For example, researchers often recommend doctors perform various screening tests. These tests are not without their risks and costs, both direct and indirect, including the impact of false-positive results. Unless we know there is some benefit of the screening that exceeds those costs, we should be reticent about telling people what they should do.

In this issue, we look at the current state of drug pricing in the United States. It appears to be a tangled mess. Are markets failing or might it be that we do not have full information on how well this market is functioning? Perhaps some legislation could help but given my experience with a lot of other health care legislation, I would not count on it.

*For the non-Trekkies among us, the remark “Damn it, Jim, I’m a doctor not a...” was repeatedly made by Dr Leonard “Bones” McCoy to Captain James T. Kirk in Star Trek: The Original Series.