The opioid epidemic continues to ravage America, with about 47,000 people dying annually. Nurse practitioners increasingly play a critical role in the fight to prevent opioid abuse. Nurse practitioners prescribe buprenorphine, work with patients in underserved and rural areas, expand access to medication-assisted treatment, and provide education and training to prescribers.
It’s a difficult battle. Despite a decade of high-profile attention, the opioid crisis has worsened in the past decade. However, with more nurses getting involved, there is hope that the number of opioid-related deaths will soon reverse into a downward trend.
The Opioid Epidemic in America
Every day in the United States, 130 people die from an opioid overdose, according to the Centers for Disease Control and Prevention (CDC). This includes both illegal and prescription opioids.
The numbers are getting worse. In 2017, 68 percent of all drug overdose deaths involved opioids, according to the CDC. The number of opioid deaths in 2017 was six times higher than in 1999.
The CDC separates the opioid epidemic into three waves. The first happened in the 1990s when the number of prescriptions for opioid painkillers skyrocketed. The second started in 2010 with an increase in heroin-related overdose deaths. The third started in 2013 with an abrupt increase in overdose deaths caused by synthetic opioids such as fentanyl.
How Nurses Can Prevent Opioid Abuse
Nurse practitioners work on the frontlines of healthcare. Among all medical professionals, they have the most direct contact with patients and their families. They have started to fill a role in healthcare once held by general practice physicians. This puts them in a position to help prevent opioid abuse.
Prescribing Buprenorphine
Buprenorphine is the first opioid dependency treatment medicine that the federal government allows physicians to prescribe and dispense. It is one of the most common treatments for opioid addiction. Buprenorphine, while producing some of the same euphoric feelings as opioids, can also reduce opioid withdrawal symptoms and has a lower risk of misuse, according to the U.S. Substance Abuse and Mental Health Services Administration.
Under the Comprehensive Addiction and Recovery Act of 2016, nurse practitioners can now prescribe buprenorphine for patients with opioid use disorder. That became permanent with the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, signed into law in October 2018.
When obtaining a Drug Enforcement Administration waiver to prescribe buprenorphine, nurse practitioners also can receive free training on the drug’s use.
Providing Care in Underserved and Rural Areas
It’s becoming increasingly difficult for patients in rural communities to find physicians in their area. According to a study in the Journal For Nurse Practitioners, about 90 percent of all nurse practitioners who can prescribe buprenorphine practice in urban areas. And 40 percent of those who are working in rural areas are not accepting new patients.
That same study, however, pointed out that nurse practitioners can have a “tremendous impact” on treating patients with opioid use disorder if they decide to practice in “rural and underserved areas.”
For those who earn a Master of Science in Nursing and become nurse practitioners, the opportunities in rural and underserved communities are large. The number of new nurse practitioner graduates is outpacing the number of new medical doctors. The federal government projects a 26 percent increase in the number of nurse practitioners between 2018 and 2028, and also notes that they are “becoming more widely recognized by the public as a source for primary healthcare.”
Expanding Access to Medication-Assisted Treatment
By working in underserved areas, and with the ability to prescribe buprenorphine, nurse practitioners can expand access to medication-assisted treatment to more patients. Medication-assisted treatment is a long-term but effective solution to opioid use disorder. The acceptance of nurse practitioners as primary care providers is key.
As noted in the study published in the Journal for Nurse Practitioners, opioid use disorder treatment is not a “quick fix.” Nurse practitioners can provide “holistic, patient-centered care” and are “well-positioned to step in and take on the role of caring for patients with OUD.”
Education and Training
Another key element in the battle against opioid abuse is education and training for prescribers. The American Nurses Association believes that the education nurse practitioners receive prepares them to “effectively and safely prescribe opioids.” The ANA also is working with 40 provider groups to provide additional education and training to more than 540,000 opioid prescribers.
Nurses will increasingly play a central part in the battle against the opioid epidemic. For those who enter the nurse practitioner profession, there will be many opportunities to make an important contribution to containing and eventually ending the epidemic.