Questions for Self Attestation for 224 and 224a

1. Do you hold a board certification in addiction psychiatry or addiction medicine from one of the following associations; American Board of Medical Specialties, American Board of Addiction Medicine, American Osteopathic Association

Yes

No

2. Have you graduated, in good standing, from an accredited school of allopathic medicine, osteopathic medicine, dental surgery, dental medicine, physician assistant, or advanced practice nursing in the United States during the 5-year period immediately preceding the date on which you first submitted a registration or renewal and the curriculum included not less than 8 hours of training ***(Click to see required curriculum)

Yes

No

1. Treating and managing patients with opioid or other substance use disorders, including the appropriate clinical use of all drugs approved by the Food and Drug Administration for the treatment of opioid use disorder or

2. The safe pharmacological management of dental pain and screening, brief intervention, and referral for appropriate treatment of patients with or at risk of developing opioid and other substance use disorders

3. Have you completed not less than 8 hours of training with one or more of the following from the approved training requirements ***(Click to see list of training providers)

Yes

No

For Physicians:

the American Society of Addiction Medicine, the American Academy of Addiction Psychiatry, the American Medical Association, the American Osteopathic Association, the American Dental Association, the American Association of Oral and Maxillofacial Surgeons, the American Psychiatric Association, or any other organization accredited by the Accreditation Council for Continuing Medical Education (ACCME) or the Commission for Continuing Education Provider Recognition (CCEPR)

For Mid-Level Practitioners:

the American Society of Addiction Medicine, the American Academy of Addiction Psychiatry, the American Medical Association, the American Osteopathic Association, the American Nurses Credentialing Center, the American Psychiatric Association, the American Association of Nurse Practitioners, the American Academy of Physician Associates, or any other organization approved or accredited by the Assistant Secretary for Mental Health and Substance Use or the Accreditation Council for Continuing Medical Education.