Summary: Some states in the US allow NPs to prescribe buprenorphine for OUD. A new study comparing outcomes from states where NPs are allowed to prescribe opioids to states where they are not shows that this did not result in an increase in high-risk prescriptions or a significant change in health outcomes.
Few states in the US have allowed nurse practitioners (NPs) to prescribe opioids to curb opioid epidemics. However, one of the latest studies shows that this did not result in better outcomes.
Not all, but few US states have allowed NPs to prescribe buprenorphine for managing opioid use disorder (OUD). The reason behind such a decision was to improve access to treatment. However, this did not result in better outcomes.
The findings of this new study were published in the JAMA Health Forum. This study compared the outcomes in states where NPs can prescribe opioids with states where they are not allowed to do so. In the study, experts did not find any statistically significant benefit.
While giving such rights to NPs may sound like a good idea, but not everyone agrees with this. Many believe that NPs are not just trained enough to handle complex OUD cases. Moreover, managing OUD is not just merely about prescribing buprenorphine. Managing OUD is quite challenging, requiring a deeper understanding of the topic.
On the other hand, supporters of these changes say that treatment access remains one of the most significant hurdles.
In this new study, researchers compared opioid prescription and outcomes by comparing the data from six states where NPs can prescribe opioids with 10 neighboring states where NPs are not allowed to prescribe opioids. This was a study done between January 2012 to December 2021. Researchers used insurance claims data from Blue Cross and Blue Shield Plans for the study. They analyzed the data of adults aged 18 to 64 years of age.
They found that in states that allowed NPs to prescribe, those did not have similar kind of demographic characteristics and opioid prescription patterns.
However, when researchers say that they did not see any change in opioid prescription to high-risk individuals, it also means that they did not find any issues with NPs prescribing these drugs. This did not increase any risk, and this did not result in overprescription or prescribing to wrongly selected patients.
Despite declining opioid prescriptions for chronic pain management, OUD remains one of the most significant problems. Prescription opioids might have played some role in this epidemic, but there are many other drivers of this epidemic. This explains why the problem continues to be relevant. Hence, many health experts have even challenged the need for reducing opioid prescriptions for chronic pain, as it might be causing more harm than good.
Thus, to manage OUD, it is essential to improve treatment access. There are a few ways of improving this access to OUD treatment, like allowing NPs to prescribe certain opioids or allowing the prescription of specific opioids through telemedicine platforms.
These new approaches to enhancing treatment access might not be making significant improvements, but studies also show that these regulatory changes are also not causing harm. Improve access to drugs like buprenorphine did not result in an increase in high-risk prescriptions.
Thus, it would be correct to say that although these new approaches might not significantly improve OUD treatment, they are not causing harm.
Source:
Cusimano, L. D., & Maestas, N. (2024). High-Risk Opioid Prescribing and Nurse Practitioner Independence. JAMA Health Forum, 5(12), e244544. https://doi.org/10.1001/jamahealthforum.2024.4544
