Legislative Wrap up:
On September 11, Governor Brown signed SB 554 (Stone), which codifies in state law the recent changes in federal law, enacted by the CARA, the Comprehensive Addiction Recovery Act, that allow NPs and PAs to receive a waiver from the DEA and the authority to prescribe medication for opioid addiction treatment Buprenorphine..
Existing federal law requires practitioners, as defined, who dispense narcotic drugs to individuals for maintenance treatment or detoxification treatment to obtain annually a separate registration with the United States Attorney General for that purpose. Existing federal law authorizes waiver of the registration requirement for a qualifying practitioner who submits specified information to the United States Secretary of Health and Human Services. Existing federal law, the Comprehensive Addiction Recovery Act of 2016, defines a qualifying practitioner for these purposes to include, among other practitioners, a nurse practitioner or physician assistant who, among other requirements, has completed not fewer than 24 hours of prescribed initial training, or has other training or experience as specified, and is supervised by, or works in collaboration with, a qualifying physician, if the nurse practitioner or physician assistant is required by state law to prescribe medications for the treatment of opioid use disorder in collaboration with or under the supervision of a physician.
WHAT IS BUPRENORPHINE:
Buprenorphine (Buprenex) is a class of opioid analgesics. This is a scheduled III drug (controlled drug) which requires a prescribers DEA license (Drug Enforcement Agency ) to prescribe. NPs and Pas typically who had completed prescribing hours has a DEA number.
Buprenorphine is used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates, such as pain relievers like morphine.Approved for clinical use in October 2002 by the Food and Drug Administration (FDA), buprenorphine represents the latest advance in medication-assisted treatment (MAT). Medications such as buprenorphine, in combination with counseling and behavioral therapies, provide a whole-patient approach to the treatment of opioid dependency. When taken as prescribed, buprenorphine is safe and effective.
Unlike methadone treatment, which must be performed in a highly structured clinic, buprenorphine is the first medication to treat opioid dependency that is permitted to be prescribed or dispensed in physician offices, significantly increasing treatment access. Under the Drug Addiction Treatment Act of 2000 (DATA 2000), qualified U.S. physicians can offer buprenorphine for opioid dependency in various settings, including in an office, community hospital, health department, or correctional facility.
Buprenorphine has unique pharmacological properties that help: Lower the potential for misuse Diminish the effects of physical dependency to opioids, such as withdrawal symptoms and cravings Increase safety in cases of overdose.Buprenorphine is an opioid partial agonist. This means that, like opioids, it produces effects such as euphoria or respiratory depression. With buprenorphine, however, these effects are weaker than those of full drugs such as heroin and methadone.
WHAT THIS MEANS TO US AND HOW IT AFFECTS HEALTHCARE:
According to Stateline, only about 10 percent of individuals with a substance use disorder receive treatment. That shortage is largely due to a dearth of providers—particularly those authorized to prescribe buprenorphine, an anti-addiction medication that prevents withdrawal symptoms and curbs cravings, Stateline reports. A federal license is needed to prescribe the drug. To help facilitate access to treatment, Congress in 2016 passed the Comprehensive Addiction Treatment and Recovery Act (CARA). Among other provisions, the law allows NPs and PAs to seek a federal license to prescribe buprenorphine. Previously, only doctors had been permitted to apply for such a license, and in the 15 years since the drug was approved, less than 39,000 doctors have sought the license.With the passing of the bill and the CARA Act there will be increase in treatment Centers utilizing NPs and PA’s to combat opioid addiction which is a current healthcare epidemic .
OTHER BILLS TO WATCH FOR:
SB 799 by Senate Business, Professions and Economic Development Committee chairman Jerry Hill passed out of the Legislature on September 13 and is awaiting the Governor’s signature. The bill extends the sunset date of the Board of Registered Nursing (BRN) until 2022. Every four years, boards operating under the Department of Consumer Affairs must undergo a “sunset review” process, by which the boards are evaluated by the Legislature and authorized to continue operating for another four years. Because the BRN protects patients while safeguarding the integrity of the nursing profession, including scope of practice and continuing education, THE California Association of Nurse Practitioners is supporting SB 799.