WASHINGTON – The United States Drug Enforcement Administration today announced a deregulatory measure that will make it easier for residents of underserved areas to receive treatment for opioid addiction.
As published today in the Federal Register, nurse practitioners and physician assistants can now become DATA-Waived qualifying practitioners, which give them authority to prescribe and dispense the opioid maintenance drug buprenorphine from their offices. Prior to the enactment of the Drug Abuse Treatment Act of 2000, only physicians could treat opioid addicts and had to register with DEA as both physicians and operators of Narcotic Treatment Programs. Waiving this second registration prompted more physicians to offer treatment services. The Federal Register notice is available here:
Today’s action brings DEA regulations into conformity with the Comprehensive Addiction and Recovery Act passed by Congress and signed into law in 2016. Because the vast majority of DATA-Waived physicians prior to CARA served urban areas, rural parts of the United States were underserved. This action provides more treatment options for addicts in rural parts of the country.
According to a 2017 report published by the National Rural Health Association, 90 percent of DATA-Waived physicians practice in urban counties, leaving 53 percent of rural counties without any prescribing physician and 30 million people living in counties where treatment is unavailable. As a result, rural patients seeking outpatient buprenorphine treatment must often travel long distances to access care. Rural providers of buprenorphine report a demand far beyond their capacity and say they lack the resources to adequately support themselves and patients in treatment. The NRHA report also found that, with 92 percent of substance use treatment facilities located in urban areas, rural areas offer fewer inpatient and day treatment resources.
Currently, there are nearly 43,000 Data-Waived qualifying practitioners in the United States. When CARA was enacted, DEA began the process of transitioning mid-level practitioners into DATA-Waived status in order to treat more addicts, and nearly 5,000 mid-level practitioners are already able to treat and prescribe opioid addicts.
In Iowa, opioid abuse is a serious problem that the state government has tried to address. According go the Iowa Department of Public Health, in 2016, Governor Branstad signed Senate File 2218 and House File 2460 into law, which increased availability of Naloxone for persons in a position to assist. Following this, State Epidemiologist Dr. Patricia Quinlisk issued a statewide “standing order” allowing a person in a position to assist in the event of an opioid overdose, to go into any participating pharmacy and purchase Naloxone without first having to see a physician.
For the past 20 years, the Iowa Department of Public Health has funded selected opioid treatment programs to provide medication assisted treatment to Iowans in the form of methadone maintenance. As approaches to medication assisted treatment continued to evolve, through its Access to Recovery (ATR) grant, IDPH began funding additional medications such as Naltrexone and Buprenorphine. In 2015, SAMHSA awarded IDPH a Medication Assisted Treatment – Prescription Drug and Opioid Addiction (MAT-PDOA) grant to further support Iowa’s efforts in addressing opioid misuse.
