Comprehensive Addiction and Recovery Act (CARA)

On July 22, 2016, President Obama signed the Comprehensive Addiction and Recovery Act (CARA) in to law.

CARA authorizes qualified nurse practitioners (NPs) and physician assistants (PAs) to become waivered to prescribe buprenorphine in office‐based settings for patients with opioid use disorder (OUD) for a five‐year period expiring in October 2021.

To qualify, NPs and PAs must:

  • Be aware of any state law regarding the treatment of addiction or OUD
  • Be licensed under state law to prescribe schedule III, IV or V medications for pain
  • Complete no less than 24 hours of appropriate education through a qualified provider
  • Through other training or experience, demonstrate the ability to treat and manage OUD
  • If required by state law, be supervised or work in collaboration with a qualified* physician to prescribe medications for the treatment of OUD

AANP was listed in the law as one of the organizations that is qualified to provide the necessary education. AANP collaborated with the American Society of Addiction Medicine (ASAM) and the American Academy of PAs (AAPA) to provide the required 24 hours of education. You can register for the courses in the AANP CE Center. By going through the AANP CE Center, you ensure that your CE certificate and a list of the completed courses will always be available in your portfolio. Additionally, AANP has accredited several programs suitable for the mandatory 24 hours of CE credit, which includes 18 hours of pharmacology credit. For questions related to education, please email CECenter@aanp.org.

The NP/PA application for the waiver is now available. For questions related to the waiver application form, please email governmentaffairs@aanp.org.

*NOTE: CARA also defers to state law regarding whether an NP or PA works with a physician through a supervisory or collaborative relationship and, where this applies, the physician must also be qualified to prescribe buprenorphine.