Finally! An X-Waiver Course Designed for EM Docs, by EM Docs!

High Quality, High Value Course Coming to a Hospital Near You!

Last fall, National ACEP commissioned a group of national EM experts in treatment of opioid addiction in collaboration with the American Academy of Addiction Psychiatry (AAAP) to develop an X-waiver course specifically for EM docs.  The course is much more case-based than the traditional course, and the learning modules have been completely revised to target the needs of EM docs, with an emphasis on pain management, acute withdrawal management, and ED buprenorphine initiation.  This project was co-chaired by our own Eric Ketcham, MD, MBA, FACEP, FASAM, FACHE and Kate Hawk, MD, MS, FACEP of Yale University. 

The course will be taught at ACEP20 in Denver, AAEM SA 2020 in Phoenix, at state and regional ACEP and other EM conferences, and at hospitals around the USA.

Course Summary:
Emergency physicians are uniquely positioned to impact the opioid epidemic because the emergency department is where these patients come for care. This course will provide the tools to turn lives around with best practice addiction treatments and satisfies 8 hours of training required by federal law to prescribe buprenorphine, the most effective treatment for opioid use disorder.  While most “X Waiver” training courses are developed for and led by psychiatrists and office-based addiction specialists, this recently approved version of the course was written by a team of EM docs, specifically for EM Docs. The MAT-EM course minimizes lecture in favor of case-based discussion, and participants will emerge from the course not only credentialed to register for their DATA 2000 (X) waiver, but prepared to manage all aspects of emergency care of OUD patients

Educational Objectives:
This course will provide the participant (with a focus on emergency providers) with a knowledge of:

  1. Opioid Use Disorder as a medical illness: dependence vs. addiction
  2. Overview and efficacy of MAT vs. non-agonist treatment
  3. Fundamentals of methadone and naltrexone treatment.
  4. Pharmacology of buprenorphine.
  5. Indications for, and dosing algorithms and potential complications of, buprenorphine administration in the ED.
  6. Management of buprenorphine precipitated withdrawal.
  7. Successful ED buprenorphine program development, and referral system. 
  8. Co-occurring psychiatric disorders and SUD disorders, with relationship to treatment of OUD.
  9. Harm reduction strategies, including rationale and evidence for community naloxone distribution, including a discussion of common misconceptions about this medication
  10. Legal & regulatory considerations, including buprenorphine prescribing rules, the “72-hour rule”, DEA license “X-waiver” patient number limits, and “42 CFR Part 2.”

More information regarding the course can be found at

Funding for this initiative was made possible (in part) by grant no. 1H79TI081968 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

In New Mexico, we will begin by running new EM focused X-waiver course at Presbyterian hospitals in August, and by December at UNM facilities as well.  There is a schedule below X-waiver courses offered by Presbyterian through December.

Additional key notes regarding the upcoming course in New Mexico:

  • The course is free.
  • Register through the links below.
  • Also note that attending an X-waiver course satisfies the 5-hour requirement for opioid training for New Mexico state medical license renewal as well.
  • Hospitalists will also likely prefer this version of the course to the traditional curriculum. [Invite your hospitalist friends to join you!]

Upcoming DATA2000 Waiver Trainings provided by Presbyterian Healthcare Services.
*Emphasis on ED Practice – all others emphasis on ambulatory care.

8.0 AMA PRA Category 1 Credits
Other Health Care Professionals will be provided a certificate of attendance or transcript for requesting credits in accordance with state nursing boards, specialty societies, or other professional associations. 

8.0 ABIM / MOC Credits
Successful completion of this CME activity, enables the participant to earn up to 8.0 MOC points (and patient safety MOC credit) in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program.

This course is also approved as meeting the New Mexico Medical Board’s Pain Management Continuing Medical Education (CME) requirement as set forth in 16.10.14 NMAC

Presbyterian Healthcare Services designates this activity for the number of AMA PRA Category 1 Credits listed above. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Mission of the Integrated Substance Use Disorder Initiative: To improve the physical and mental health status of people with substance use disorder(s) by creating a system of care that provides high quality treatment/interventions and seamless transitions between all settings of care and the recovery community.