Opioid CME requirements by state: 13-state guide

Opioid CME requirements by state vary more than almost any other mandated topic. Some states want a few hours every renewal, some want one course in your career, and a few only apply the rule to pain clinic physicians.

We checked these requirements against each state medical board’s website or administrative code. Rules change, so confirm with your state medical board before your renewal.

The short answer

All 13 states we checked have some form of pain management, opioid, or controlled substance CME rule, but who it covers differs a lot.
Most states tie the requirement to prescribing, so physicians without a DEA registration or who don’t prescribe controlled substances are often exempt.
For most prescribers the recurring requirement is small, from 1 credit per renewal in New Jersey to 4.5 hours per cycle in Kentucky, while pain clinic rules in Ohio and Georgia call for 20 hours.
In most states these hours count toward your total CME, not on top of it.
The federal DEA 8-hour training is a separate, one-time obligation tied to your DEA registration, not your state license.

Opioid CME requirements by state: confirmed table

The table covers MDs unless noted. “Each cycle” means every renewal period for that state. For general totals and other mandated topics, see our CME requirements by state hub.

State	Who it applies to	Requirement	How often
California (MD)	Most physicians (pathology and radiology exempt)	12 hours in pain management and care of terminally ill and dying patients, including Schedule II addiction risks, or a 12-hour course on opiate-dependent patients	One time
California (DO)	Osteopathic physicians	A course on addiction risks of Schedule II drugs, plus the same one-time 12 hours	Each cycle (Schedule II course)
Florida	DEA-registered prescribers	2 hours, board-approved course on prescribing controlled substances	Each biennial renewal
Texas	Physicians in direct patient care	2 hours in pain management and opioid prescribing	Within 1 year of licensure, again at second renewal, then every 8 years
Pennsylvania	Prescribers and dispensers under ABC-MAP	2 hours in pain management, identifying addiction, or opioid prescribing or dispensing	Each biennial renewal
Ohio	Physician owners of pain management clinics only	20 hours of Category I CME in pain medicine, including addiction potential	Every 2 years
Georgia	DEA holders who prescribe controlled substances	3 hours of AMA/AOA PRA Category 1 CME on controlled substance prescribing	Once in your career
Georgia (pain practice)	Physicians without pain or palliative certification whose opioid pain management patients make up 50% or more of their patients	20 hours in pain management or palliative medicine	Every 2 years
North Carolina	Physicians who prescribe controlled substances	3 of the 60 Category 1 hours on controlled substance prescribing	Each 3-year cycle
Michigan	All physicians renewing	3 hours in pain and symptom management, at least 1 on controlled substance prescribing	Each 3-year cycle
New Jersey	All physicians	1 of the 40 Category I credits on prescription opioid drugs	Each biennial renewal
Massachusetts	Physicians who prescribe controlled substances	3 credits in opioid education and pain management	Each licensing cycle
Kentucky	Physicians authorized to prescribe or dispense controlled substances in Kentucky	4.5 hours on KASPER, pain management, addiction disorders, or a combination	Each 3-year cycle
Tennessee	DEA-registered prescribers of controlled substances (some specialties exempt)	2 of the 40 hours on controlled substance prescribing, including the state’s chronic pain guidelines	Each biennial renewal
West Virginia	Physicians who prescribed, administered, or dispensed controlled substances under a West Virginia license	3 hours of board-approved CME in risk assessment, responsible prescribing, and drug diversion	Each 2-year reporting period

State notes worth reading before you renew

California

The Medical Board of California treats its 12-hour pain management requirement as a one-time course within the 50-hour biennial total. Pathologists and radiologists are exempt. The Osteopathic Medical Board of California adds a recurring course on the addiction risks of Schedule II drugs, which must be completed every renewal cycle.

Florida

Florida Statutes section 456.0301 requires DEA-registered prescribers to complete a board-approved 2-hour controlled substance course as part of each biennial renewal. The statute says the department may not renew the license of a registrant who skips it. Course content now includes treating pain in patients with sickle cell disease.

Texas

Texas runs on its own schedule. Physicians in direct patient care complete 2 hours of pain management and opioid prescribing CME within a year of licensure, again with the second renewal, and then every 8 years. The board’s general requirement is 48 credits every 24 months.

Ohio

Ohio’s general renewal rule is 50 hours every two years with a one-hour duty-to-report course. The board’s physician renewal page lists no opioid course for all physicians. The pain medicine hours in Rule 4731-29-01 apply to physician owners of licensed pain management clinics.

Georgia

Georgia’s 3-hour controlled substance course is needed only once in a career. The 20-hour pain management requirement is separate and recurring. The board’s web page describes that group as physicians who work in a pain clinic without pain or palliative certification, so check the rule text if you think it might apply to you.

Tennessee

The Tennessee board lists exemptions under state law for providers at a registered pain management clinic and for physicians board certified in pain management, anesthesiology, physical medicine and rehabilitation, neurology, or rheumatology.

West Virginia

The West Virginia Board of Medicine says plainly that this is not a one-time requirement. Physicians who did not and will not handle controlled substances under a West Virginia license during the period can request a waiver by attestation. Board certification and MOC options do not waive the 3-hour course.

The federal DEA 8-hour training is separate

Since June 27, 2023, the DEA has required practitioners who hold or apply for a DEA registration (other than those who are solely veterinarians) to complete a one-time, 8-hour training on treating and managing patients with opioid or other substance use disorders. You attest to it on your next initial or renewal registration application.

According to the DEA’s Q&A, the 8 hours can be completed all at once or in pieces, and past DATA-waived trainings count. The DEA lists the kinds of organizations whose training qualifies, including ACCME-accredited providers. It’s a federal registration requirement, so it doesn’t replace your state board’s topic mandate, and a state course doesn’t automatically satisfy it. Check the DEA’s guidance and your board’s rules separately.

How to plan your hours

Start with your board’s own list. Several states, including Florida, Kentucky, and West Virginia, require a board-approved course, so a general opioid lecture may not count even if it carries AMA PRA Category 1 Credit™. Before you sign up, confirm the course is on your board’s approved list or meets its stated content rules.

If you hold licenses in more than one state, map each deadline and cycle length. A Texas physician with a Michigan license faces an every-8-years rule in one state and a 3-hour requirement every 3 years in the other.

Once your mandated topics are handled, the rest of your hours can go toward clinical material you’ll use. Travel Medical Seminars offers Audio-Digest self-study courses in 10-credit and 20-credit formats, including a pain management course and a DEA requirements and substance abuse course, all studied at your own pace with online testing. Check each program’s materials, and your board’s rules, to see whether it is approved for a specific state or DEA requirement. You can also browse all courses.

Opioid CME requirements by state for physicians