The Evolving Role of Nursing
Nurses see firsthand the devastating effects of the opioid crisis on their patients, communities, and perhaps even 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 crisis. The combined efforts of the Trump administration, federal agencies, lawmakers at all levels of government, and health care advocates across the country is being applauded. Along with 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: over 67,000 Americans lost their lives to drug misuse in 2018, a decrease of 4% from 2017. However, 70% of those overdoses involved a prescription or illicit opioid. The number of people misusing prescription opioids in 2018 is even more alarming, 10.3 million people. There is hope—however, a comprehensive approach from community-based programs to government action at every level is needed to address this 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), that within the walls of Congress there are currently 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 permanent authorization to prescribe MAT.
A bill that ANA continues to monitor in this Congress is the Mainstreaming Addiction Treatment Act of 2019 introduced in the House as H.R. 2482 by Congressman Paul Tonko (D-NY-20) and in the Senate as S. 2074 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 just one 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, which has proven effective in stemming SUDs. For further information and resources, please click here.