Healthcare Reform: Nurses Impact Policy
August 29, 2017
Response by Andrea Brassard to “Opiate Crisis and Healthcare Reform in America: A Review for Nurses” by Susan G. Painter (May 31, 2017)
I am writing in response to the May 2017 article, titled “Opiate Crisis and Healthcare Reform in America: A Review for Nurses” (Painter, 2017). While this article included information about the Affordable Care Act and other changes in state and federal policy that affect opiate treatment, the Comprehensive Addiction and Recovery Act (CARA) (Congress.gov, 2016) was omitted. One of CARA’s important provisions is expanding access to medication assisted treatment (MAT) by allowing nurse practitioners (NPs) and physician assistants (PAs) to prescribe buprenorphine in office-based settings (SAMHSA, 2017). Details about required training are available on the Substance Abuse and Mental Health Services Administration (SAMHA), the American Association of Nurse Practitioners (AANP), and the American Psychiatric Nurses Association (APNA) websites. Training is free but this opportunity is time limited, as the CARA provision allows NPs and PAs to prescribe buprenorphine only until October 1, 2021. If few NPs sign up for this prescribing waiver, this federal provision may end.
It is unfortunate that CARA did not expand buprenorphine prescribing to clinical nurse specialists (NACNS, 2016). Clinical nurse specialists (CNSs) have been substance abuse providers for decades (Kub, 2008). The nursing community should join with the American Psychiatric Nurses Association’s advocacy for inclusion of CNSs in CARA (APNA, 2016).
As Dr. Painter (2017) writes, “our nation is in a race against time to positively impact…[the opioid] crisis” (Abstract). It’s vitally important that we get the word out about this opportunity for NPs and all nurses to help ameliorate the opioid crisis.
Andrea Brassard, PhD, FNP-BC, FAANP,
Center to Champion Nursing in America at AARP
American Association of Nurse Practitioners. (2016). CARA act. Retrieved from http://media.aanponline.com/psa/information.pdf
American Psychiatric Nurses Association. (2017). Medication assisted treatment waiver training for APRNs. Retrieved from https://www.apna.org/i4a/pages/index.cfm?pageid=6197
American Psychiatric Nurses Association.(2016). Inclusion of CNS in CARA 2016. Retrieved from https://www.apna.org/i4a/pages/index.cfm?pageID=6239
Kub, J. (2008). An interview with Kietha Taylor, MSN, APRN,BC, Clinical nurse specialist in addictions. Journal of Addictions Nursing, 19, 217-219.
National Association of Clinical Nurse Specialists. (2016, July 25). Clinical nurse specialists call comprehensive addiction and recovery act ‘good start’ but say it falls short. Retrieved from http://nacns.org/2016/07/clinical-nurse-specialists-call-comprehensive-addiction-and-recovery-act-good-start-but-say-it-falls-short/
Comprehensive Addiction and Recovery Act of 2016, Pub. L. 114-198, 130 STAT. 695, codified as amended 114 U.S.C. 198. §524. Retrieved from https://www.congress.gov/bill/114th-congress/senate-bill/524/text
Substance Abuse and Mental Health Services Administration (SAMHSA). (2016). Qualify for nurse practitioners (NPs) and physician assistants (PAs) waiver. Retrieved from https://www.samhsa.gov/medication-assisted-treatment/qualify-nps-pas-waivers