Nurses see firsthand the devastating effects of the opioid crisis on their patients, communities, and perhaps themselves or their families. ANA members have been forthcoming in their stories about the barriers to access, treatment, and the pain they have dealt with each day working to fight this ongoing crisis, along with the second pandemic of COVID-19. The combined efforts of the federal agencies, lawmakers at all levels of government, and health care advocates across the country are being recognized to address the new barriers created by COVID-19, while addressing the existing barriers to treatment that were already in place to many desperately seeking help. In addition to emergency responders, law enforcement, and other health care providers, nurses everywhere are assisting patients throughout their journey to turn the tide on the devastating effects of opioid and substance abuse in local communities.
The statistics are sobering: more than 81,000 Americans lost their lives to drug overdoses in a 12-month span between May 2019 and May 2020. This is the highest number of overdose deaths ever recorded in a 12-month period in the United States. While numbers were increasing by the end of 2019 and into the early months of 2020, the COVID-19 pandemic has disrupted treatment options available to many. This large increase of overdose deaths continues to be from synthetic opioids, rather than prescription opioids. A comprehensive approach from community-based programs to government action at every level is needed to address this ongoing crisis.
Combating the opioid epidemic presents a complex set of challenges, from pain management to Substance Use Disorder (SUD) treatment and recovery and access to Medication Assisted Treatment (MAT). During the past two Congresses, there have been dozens of bills aimed at addressing this issue. ANA scored a major victory when the SUPPORT for Patients and Communities Act (H.R. 6) became law in 2018 which gives nurse practitioners and physician assistants permanent authorization to prescribe MAT. It also grants clinical nurse specialists, certified registered nurse anesthetists, and registered nurse-midwives the authorization to prescribe MAT through 2023. A bill that ANA continues to monitor in this Congress is the Mainstreaming Addiction Treatment Act of 2021 introduced in the House as H.R. 1384 by Congressman Paul Tonko (D-NY-20) and in the Senate as S. 445 by Senator Maggie Hassan (D-NH). The bill aims to eliminate the separate registration requirement for dispensing narcotic drugs in schedule III, IV, or V (such as buprenorphine) for maintenance or detoxification treatment. Current law requires prescribers to apply for a waiver in order to prescribe buprenorphine to treat addiction after completing a multi-hour educational course.
Buprenorphine, however, is just one piece of the puzzle in treating opioid dependency. As with all medications used in MAT, it is part of a comprehensive treatment plan that includes addressing the underlying issues through complementary and alternative therapies, counseling, and participation in social support programs. Nurses play a primary role in comprehensive treatment plans as well as care coordination and will continue to be integral in treating the most vulnerable populations throughout the country.
ANA supports nurses who are facing this crisis head on through targeted continuing education, backing federal legislation that allows nurses to practice to the full extent of their training and education, providing recommendations to federal agencies on solutions to address access, scope of practices, and education barriers, and advocating for policies that allow APRNs to prescribe MAT. For further information and resources, please click here.