Half and Half Course

In response to feedback from trainees taking the 8-hour, one day course that leads to waiver eligibility to use buprenorphine in office-based practice for opioid use disorders, the AAAP developed a new way of training which is called the "Half and Half" Course - 3.75 hours of on-your-own-training and 4.25 hours of face-to-face training with an instructor. This course is now being used to train physicians as part of the Physicians' Clinical Support System for Buprenorphine (PCSS-B) which is supported by the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (CSAT/SAMHSA).

One "half" of the course is 3.75 hours of CD training containing modules that provide background in substance abuse treatment and specifically in treatment of opioid use disorders and use of buprenorphine. An examination in the trainee materials packet much be completed, and sent to the sponsoring organization for the course, either AAAP or AOAAM, or brought to the Course Director at the face-to-face training. (Instructions for taking and sending the examination will be available in the trainee CD along with registration materials). The CD should be reviewed and examination completed before the classroom experience occurs.

The other "half" of the course is a classroom-style training with small (approximately 20 trainees per trainer) groups in a 4.25 hour face-to-face training with a course director who has already obtained the waiver to practice with buprenorphine and is doing so in his/her community. The training will focus on clinical vignettes to help trainees think through "real life" experiences in opioid use disorders treatment and will have several "overview" lectures that will provide a knowledge base necessary for this practice.

The combined face-to-face and CD training will provide the 8 hours needed to obtain the waiver to prescribe buprenorphine in office-based treatment of opioid use disorders.

Here's How it Works

  • When you learn of a "Half and Half" Course in your area or when your institution is offering a course, obtain a CD from the Course Director or from the sponsoring group (either AAAP or AOAAM) with required modules and examination.
  • Review the modules on the Trainee CD for the "Half and Half" course.
  • Print out the examination on the CD and complete it. Print out and complete registration materials. Send the examination, registration and course fee (note: there is no course fee for residents) to the sponsoring organization (AAAP or AOAAM) at the address listed or bring the materials to your Course Director on the day of the training.
  • Attend the face-to-face training. Make sure you sign in and out of the training and sign for permission for your sponsoring organization (AAAP/AOAAM) to release information to CSAT regarding your qualification for the waiver.
  • Apply for the waiver at the face-to-face training (if you wish to do so - you can apply for the waiver at any point after completing the training).
  • Staff at the sponsoring organization will verify that you have completed the 8 hours of training and will certify your waiver eligibility to CSAT.
  • If you miss the face-to-face training, you must complete the required training at another "Half and Half" training or you may want to complete the 8-hour online course. Contact PCSS-B at www.pcssb.org, info@pcssb.org, or call (888) 5-PCSS-B-4U for a listing of training options.

Progam Goals and Objectives

After participating in this course, participants will be able to:

  • Gain knowledge of how to identify and treat substance use disorders in outpatient medical settings
  • Identify the clinically relevant pharmacological characteristics of buprenorphine
  • Describe the resources needed to set up office-based treatment with buprenorphine for patients with opioid use disorders
  • Describe and contrast the functions of opioid agonists, partial opioid agonists and antagonists
  • List special treatment considerations associated with adolescent opioid-dependent patients and list factors to consider in evaluation of a pregnant opioid-dependent woman
  • Describe symptoms of opioid withdrawal or intoxication that mimic symptoms of a mental disorder
  • Gain an understanding of clincal practice with buprenorphine including patient assessment, buprenorphine induction maintanance and medical withdrawal via lectures, online modules, and cinical vignettes
  • Identify and provide or refer buprenorphine-treated patients for ongoing substance abuse psychosocial treatment
  • Identify and describe treatment considerations for patients with co-occurring medical or mental illness
  • Gain an understanding of the special confidentiality requirements for treatment of patients with substance use disorders
  • Gain an understanding of special requirements of substance abuse treatment including the importance of urine drug screening

Drug Addiction Treatment Act of 2000

The Drug Addiction Treatment Act of 2000 (PL-106-310, Section 3502) permits physicians who are trained or experienced in opoid addiction treatment to obtain waivers to prescribe certain narcotic drugs in Schedule III, IV, or V of the Controlled Substances Act in their office practices or in a clinic setting, for the treatment of opioid use disorders. Both buprenorphine and the combination of buprenorphine with naloxone are approved by FDA for use in the detoxification and maintenance treatement of opioid use disorders.

Physicians are qualified if they are certified in Addiction Medicine or Addiction Psychiatry. As part of the requirements to obtain the waiver, physicians not otherwise qualified must complete not less than 8 hours of training. Physicians who complete this 8-hour training regimen will meet the training qualification under the law and can complete teh waiver application to the Secretary of the U.S. Department of Health and Human Services (DHHS). The American Academy of Addiction Psychiatry or American Osteopathic Academy of Addiction Medicine will certify completion of the training for individual physicians upon obtaining proof of such training completion. Proof of training completion will be based on a passing score on the examination on the Trainee CD for the "Half and Half" Course plus signing a log at the beginning and end of the face-to-face component of the course verifying participation.

Who Should Attend

This program is recommended for physcians with experience and/or interest in treating opioid use disorders. This program is also recommended for primary care, psychiatric, HIV and addiction medicine specialists.

Continuing Medical Education Credit

Payment for this course, if any, includes administrative costs to the sponsoring group (AAAP or AOAAM) for verification of waiver eligibility. Please notify your sponsoring organization to determine if CME credits are provided and related cost. Note: Resident physicians do not have to pay course fees and they do not receive CME for taking this course.

If You Would Like to Complete a Half and Half Training

Please Click Here for an Application

Additional Information

For information on the PCSS-B please visit www.pcssb.org, email info@pcssb.org,
or call (888) 5-PCSS-B-4U (888-572-7724).