Nurse Practitioners Essential in Combating Opioid Epidemic

Last year, 1 out of every 3 American adults was given a prescription for opioid painkillers like oxycodone, hydrocodone, or morphine to manage pain. For anyone suffering from intense pain, these medications are a critical component of care, but they don’t come without serious risk.

Today, we know opioid painkillers are both effective and addictive, posing important relief alongside serious threats to patients prone to addiction. More than 2 million people abuse their prescription pain relievers, and for the first time, drug overdose fueled by the opioid crisis is the leading cause of injury-related death in the U.S. – even above car accidents and firearms. Today, more than 20 percent of people taking opioid painkillers for chronic pain – or as many as 1 in 4 – misuse their medication, and roughly 10 percent become addicted.

It has been almost a year since the Comprehensive Addiction and Recovery Act (CARA) was signed into law, marking rare bipartisan support to address the growing incidence of opioid abuse disorder, which affects approximately 3 million Americans. The new law recognizes the benefit nurse practitioners (NPs) bring to combatting the opioid epidemic.

With more than 234,000 licensed professionals nationwide, the burgeoning ranks of NPs signal to be a game changer in the war on opioid addiction. Among CARA’s provisions NPs can seek a federal waiver allowing them to prescribe anti-addiction medications like buprenorphine to prevent withdrawal symptoms. Previously this waiver was available only for physicians, but in the 15 years since the drug was approved, little more than 4 percent (or roughly 32,000 of the 800,000 U.S. physicians) have been certified. 

With the profession’s double-digital growth and 1 billion patient visits annually, NPs are positioned as an essential component in the fight to solve the epidemic. Since the legislation was enacted, the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA) have already issued relevant licenses to 560 NPs, and applications will continue to increase as more NPs complete the training available to obtain the waiver.

CARA need not be the only weapon in the fight against opioid abuse. As progress continues on Capitol Hill to further new proposals for better access to opioid addiction treatments, states should also consider enacting legislation removing barriers to access for patients seeking treatment.

Today, outdated laws in some states prevent NPs from fully utilizing their education and training to combat the opioid crisis and address the critical access challenge facing patients. 22 states and the District of Columbia have removed these legislative obstacles by embracing full practice authority, which gives patients direct access to NP care. Increasingly, there is bipartisan support in state capitals nationwide to build on this trend.

We already know that removing legislative barriers for NPs to provide autonomous care can dramatically improve patient outcomes, and when we talk about addiction, that means saving lives. For states like Pennsylvania, with an overdose death rate among the highest in the nation and scope-of-practice laws that prevent NPs from fully utilizing their skills and training to treat patients, it is time to enact full practice authority.

The good news is NPs are ready and available to lead. Last year, NP graduates in primary care outnumbered their medical school counterparts by more than three times, and job growth for NPs is projected to jump 31 percent between now and 2024.

Every day, 91 people die from opioid overdose, and this number is on the rise in part because half of all U.S. counties lack a single health care provider certified to treat addiction. With hundreds of thousands of NPs ready to provide the care needed to help stem the tide of this increasing threat to our families and communities, we must empower them to do so.

As we stare-down mounting challenges to health care access, such as the critical need to expand opioid addiction treatment, granting patients direct access to NP care is an obvious solution.

David Hebert is the Chief Executive Officer of the American Association of Nurse Practitioners (AANP).

The views expressed above belong solely to the author.