DEA rules NPs, PAs can now prescribe opioid addiction medications — 6 key insights

The DEA now allows nurse practitioners and physician assistants to prescribe and dispense FDA-approved opioid addiction medications for opioid use disorders, Medscape reports.

Here are six things to know:

1. The 2016 Comprehensive Addiction and Recovery Act mandated a three-year pilot that allowed advanced NPs and trained PAs to prescribe buprenorphine. A final DEA rule makes that permanent.

2. The DEA estimates that 5,000 NPs and PAs have been prescribing and dispensing buprenorphine, compared to 43,000 physicians. Corey Waller, MD, chair of the American Society of Addiction Medicine's Legislative Advocacy Committee told Medscape Medical News he believes at least 25,000 NPs and PAs would be interested in prescribing and dispensing buprenorphine. Dr. Waller is the senior medical director for education and policy at the National Center for Complex Health and Social Needs/Camden Coalition of Healthcare Providers in New Jersey

3. Under CARA, NPs and PAs are eligible if they are licensed under state law to prescribe schedule III, IV or V medications for the pain treatment and if they receive at least 24 hours of initial training. State laws requiring physician supervision will continue to apply.

4. The DEA claimed this policy change will benefit people with opioid use disorders in rural areas. A 2017 National Rural Health Association report found that 90 percent of physicians approved to prescribe medication-assisted therapy were in urban counties. Half of rural counties did not have any prescribing physician, and 30 million people lived in counties where treatment was unavailable. The vast majority — 92 percent — of substance use treatment facilities were in urban areas.

5. Dr. Waller notes that many NPs and PAs are the first-line providers for patients with substance use disorders in emergency departments and clinics.

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