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Research has repeatedly shown that barriers preventing advanced practice registered nurses (APRNs) from practicing at the top of their licensure have the potential to negatively impact our nation's health.
As the United States continues work to address the ongoing opioid crisis, patient access to substance use disorder (SUD) treatment remains a significant barrier. NPs are well positioned, with graduate degrees and advanced clinical training, to assess patients, order and interpret diagnostic tests, develop treatment plans and prescribe medications. A study also found that NPs are more likely to practice in rural and underserved regions, particularly among states with higher numbers of opioid use and abuse.
In a recent article for The Journal for Nurse Practitioners (JNP), AANP State Policy Coordinator Julia Dieperink, MA, and AANP Research Specialist Chantel DePaepe, MPH, examined the results of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) Act. This act, which was signed into law in October 2018, permanently authorizes NPs to prescribe MATs once they have obtained a buprenorphine waiver from the Substance Abuse and Mental Health Services Administration (SAMHSA).
Overall, the number of NPs with buprenorphine waivers has substantially increased. NPs in Full Practice Authority states were also found to be more likely to have a buprenorphine waiver than those in Reduced or Restricted States.
Hear from practicing NPs—and AANP members—on their experience obtaining the critical buprenorphine waiver.
"I am a chronic pain specialist and often identify opioid use disorder in my clinical practice. Due to state law prohibiting nurse practitioners from prescribing buprenorphine for dependence, I am unable to effectively treat the patients I diagnose with opioid use disorder. Unfortunately, there is a great need for MAT providers, and assisting these patients with getting access to this lifesaving treatment can be difficult to navigate. In my practice, I often identify opioid use disorder and initiate these vital conversations with patients. If I were able to prescribe buprenorphine for dependence, transition into effective treatment would be seamless, providing our patients with immediate access to care. Currently, I communicate diagnostic criteria for opioid use disorder and oftentimes assist patients in realizing they need treatment. I develop a rapport with these patients and would greatly like to help them, as well as my physician colleagues, by becoming a DEAX provider, but Tennessee state law prohibits my contributions." — Heather J., MSN, APRN-BC, Tennessee, Member since 2013
"When I was completing my NP program, a classmate gave a training on SUD. This immediately seemed to me like an exciting, effective way to treat opioid use disorder [OUD]. It’s a big thing to take on — there's a huge need and not nearly enough providers are doing it. I gained support from the University of North Carolina at Chapel Hill Extension for Community Healthcare Outcomes for Rural Primary Care Medication-assisted Treatment [UNC ECHO for MAT] program, which entails a weekly, hour-long video call with health care providers at UNC and others entering this space. It lets me be a part of a community of providers who are learning and are interested in the same thing. They really generously allowed me to continue being part of it even after I moved to Alaska. When I moved, I needed pharmacology continuing education [CE], so I completed the MAT waiver training this summer. There is a huge issue with OUD in Alaska, and access to care is a challenge. For example, I'm a medical provider for a remote village of about 34 people once a month. MAT is really the only evidence-based treatment for OUD, but there aren't many providers waivered here in the islands where I practice. It can mean the difference between treatment and no treatment at all." — Gregory W., FNP-C, Alaska, Member since 2018
If you believe in increasing patient access to MATs through the adoption of Full Practice Authority for NPs, become an advocate! Share the Nurse Practitioners: Improving Patient Outcomes for Opioid Use Disorder infographic with your colleagues and policymakers. The infographic can help you explain why it’s important for the U.S. to retire outdated laws that stand between patients and the opioid use disorder treatment they deserve.
Take time to complete the free 24-hour Buprenorphine Waiver Training provided by AANP in collaboration with the American Society of Addiction Medicine and the American Academy of Physician Assistants.
This training provides valuable information for assessing, screening, referring and treating patients with substance use disorder. Help your community by increasing access to critical MAT treatment!