APRNs and buprenorphine
Advanced Practice SIG Members and Followers:
The AMERSA Board of Directors endorsed a letter to The Honorable Sylvia Mathews Burwell, Secretary U.S. Department of Health and Human Services, sent November 18, 2016. Signed by President J. Paul Seale, the letter was drafted by the AMERSA Nursing Special Interest Group (SIG) at the 2016 AMERSA Annual Meeting. There was considerable discussion about and celebration of the Comprehensive Addiction and Recovery Act (CARA; P.L. 114-198). In this law, “Nurse Practitioner” is specified as a “qualified other practitioner,” who once a waiver is obtained, will be able to prescribe buprenorphine.
The Nursing SIG advocated for the importance of recognizing Advanced Practice Registered Nurses (APRNs) as “qualified other practitioner[s].” Thus, the letter pointed out that “it is important to recognize that ‘Nurse Practitioner’ is just one APRN title that can be a ‘qualified other practitioner’.”
The letter briefly explained that there are other APRN titles that currently meet the CARA-specified criteria and who have prescriptive ability. These APRNs include Certified Nurse Midwife (CNM), Clinical Nurse Specialist (CNS), and Certified Registered Nurse Anesthetist (CRNA). The letter stated, “Within the scope of the law as it is written, our goal is to maximize the positive impact that all eligible nurses can have in expanding access to known successful treatments for opioid use disorder.” CARA stipulates that, “The Secretary may, by regulation, revise the requirements for being a qualifying other practitioner under this clause.” Thus, with that stipulation in mind, the AMERSA Board of Directors asked Secretary Burwell to revise and expand the definition of qualifying practitioners to include all APRNs with prescriptive authority.
We recognize that the intended outcome expanding the definition to all APRNs with prescriptive authority may not be realized in the short term. Importantly by taking this action, we are enacting the mission of this organization as”interdisciplinary leaders in substance use education, research, care, and policy.” With this action, the AMERSA Board of Directors is in full support of the Institute of Medicine’s 2010 report “The Future of Nursing” which recommends all nurses should practice to the full extent of their training and licensure, and should be full partners with physicians and others in health care.