Pubdate: Thu, 28 Apr 2016
Source: Buffalo News (NY)
Copyright: 2016 The Buffalo News
Author: Christene Amabile
Note: Christene Amabile, FNP- BC, CARN- AP, of Grand Island, is a 
family nurse practitioner.


The article, "On track for 570 opiate deaths in 2016, Erie County 
steps up response," in the April 6 Buffalo News in part focused on 
the shortage of health care providers who can prescribe medication 
assisted treatment for opiate use disorders.

It noted the small number of physicians who are certified to 
prescribe buprenorphine ( trade names: Suboxone, subutex and 
Zubsolv). Even when certified, physicians can prescribe to only 100 
clients at a time.

Unfortunately, although nurse practitioners ( NPs) and physician 
assistants ( PAs) provide medical care to millions of people daily, 
and are an integral part of health care, a federal law created in 
2000 prohibits NPs/ PAs from prescribing buprenorphine to treat 
addictions. Buprenorphine is a schedule III controlled substance, 
which when utilized as prescribed does not induce a "high" and has 
less risk for overdose than do other prescription opioids and heroin. 
Ironically, NPs and PAs can prescribe buprenorphine for pain management.

As a nurse practitioner with a subspecialty in addiction medicine, it 
is an ongoing struggle to provide individuals with timely and 
effective treatment given the current regulations.

The alarming shortage of providers who can prescribe buprenorphine 
makes the treatment inaccessible to individuals in need. Imagine that 
you were in a serious car accident and subsequently prescribed opioid 
analgesics by a pain specialist. Although the medication was 
carefully monitored, eventually you started using more than what was 
prescribed. Although no longer in pain, now you are addicted to 
opioids. So, you seek out an easily accessible and inexpensive 
substitute: heroin.

You decide that it is time to get help because your entire life is 
crumbling. You call your primary care provider ( an NP), who provides 
all your medical care, medications, etc. You explain your situation 
and that you are interested in buprenorphine. She regrets to tell you 
that even though she is also certified in addiction medicine she 
cannot give you a prescription for the medication. And, you might 
need to wait at least a few weeks and maybe more to get an 
appointment with a physician who can prescribe buprenorphine.

Allowing NPs/ PAs with addiction medicine training seems an obvious 
and inexpensive way to assist with the shortage of treatment 
providers. We have the potential workforce to meet the demands of 
this crisis and are not utilizing it. Proposed federal legislation 
known as the TREAT Act would allow nurse practitioners and physician 
assistants to prescribe buprenorphine for addiction. It would also 
eliminate the 100- client limit for physicians.

This national crisis is affecting everyone. Please assist now by 
voicing your concerns.
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MAP posted-by: Jay Bergstrom