Many NPs Unable to Prescribe Meds to Treat Opioid Addiction

Greater practice restrictions are associated with a lower percentage of nurse practitioners (NPs) with waivers to prescribe buprenorphine, but no association is seen for physician assistants (PAs), according to a study published in the April 9 issue of the Journal of the American Medical Association.

Joanne Spetz, Ph.D., from the University of California in San Francisco, and colleagues examined the proportions of NPs and PAs with waivers in 2018 and the correlation with state regulations restricting their scope of practice. The scope of practice was measured as a binary variable.

The researchers found less restrictive regulations in 27 and 23 states for NPs and PAs, respectively. Overall, 5.57 percent of all physicians, 3.17 percent of NPs, and 1.66 percent of PAs had waivers to prescribe buprenorphine. Correlations between the state-level percentages of physician and NP waivers and between physician and PA waivers were 0.80 and 0.63, respectively. The mean percentage of NPs with waivers was 5.58 and 2.44 percent in less and more restrictive states, respectively. After multivariable adjustment controlling for the percentage of physicians with waivers, the adjusted percentage of NPs with waivers was 4.73 and 2.03 percent in less and more restrictive states, respectively. There was no significant correlation between PA scope of practice and percentages of PAs and physicians with waivers in unadjusted or adjusted analyses.

"The results of this study suggest that states in which NP practice is restricted may be less able to expand the opioid treatment workforce," the authors write.

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