{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:41:53Z","timestamp":1773675713433,"version":"3.50.1"},"reference-count":57,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["F31NR019929"],"award-info":[{"award-number":["F31NR019929"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["sigmapubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Nursing Scholarship"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Drug overdoses have reached a historic milestone of over 100,000 deaths in a single year, 75,673 related to opioids. The acceleration in opioid\u2010related deaths coupled with stark health inequities demands a close examination of opioid use disorder (OUD) treatment barriers and swift consideration of policy changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>The aim of this buprenorphine policy analysis is to summarize existing buprenorphine barriers and present policy solutions to improve access and actualize the contributions of Advanced Practice Registered Nurses (APRNs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The policy analysis follows five sequential steps: (1) defining the problem, (2) identifying key stakeholders, (3) assessing the landscape of relevant policies, (4) describing viable policy options, and (5) making final recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Although there are laudable efforts to improve buprenorphine access, such as the new buprenorphine guidelines issued in April 2021, without larger\u2010scale changes to federal, state, and scope of practice laws, overdose rates will continue to rise. We recommend a multipronged policy approach to improve buprenorphine treatment access, including eliminating the DEA X waiver, improving OUD education, and adopting full practice authority for APRNs in all states.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Incremental change is no longer sufficient to address opioid overdose deaths. Bolder and coordinated policy action is possible and necessary to empower the full clinical workforce to apply evidence\u2010based life\u2010saving treatments for OUD. The critical contributions of nurses in advancing equitable access to OUD care are emphasized in the National Academy of Medicine's Report, Future of Nursing: Charting a Path to Achieve Health Equity. Nurses are named as instrumental in improving buprenorphine access. Policy changes that acknowledge and build on evidence\u2010based treatment expansion strategies are sorely needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Relevance<\/jats:title><jats:p>One of the most robust tools to combat opioid overdose deaths is buprenorphine, a partial opioid agonist, and gold standard medication treatment for OUD, but only 5% of the prescribing workforce possess the required Drug Enforcement Agency (DEA) X waiver. A growing body of evidence demonstrates that Advanced Practice Registered Nurses are accelerating the growth in waiver update and buprenorphine use, despite the considerable barriers and limitations described in this policy analysis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jnu.12871","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T05:19:07Z","timestamp":1673327947000},"page":"655-664","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Eliminate the buprenorphine <scp>DEA<\/scp> X waiver: Justification using a policy analysis approach"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0825-8394","authenticated-orcid":false,"given":"Katie Fitzgerald","family":"Jones","sequence":"first","affiliation":[{"name":"Division of Palliative Care and Geriatric Medicine Massachusetts General Hospital, Mongan Institute for Aging and Serious Illness  Boston Massachusetts USA"},{"name":"Boston College, William F. Connell School of Nursing  Chestnut Hill Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"O\u2019Reilly\u00a0Jacob","sequence":"additional","affiliation":[{"name":"Boston College, William F. Connell School of Nursing  Chestnut Hill Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Spetz","sequence":"additional","affiliation":[{"name":"Philip R. Lee Institute for Health Policy Studies, University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurie","family":"Hailer","sequence":"additional","affiliation":[{"name":"Independent Consultant  Fairfax California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4531-9317","authenticated-orcid":false,"given":"Matthew","family":"Tierney","sequence":"additional","affiliation":[{"name":"Office of Population Health, UCSF Health University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103877"},{"key":"e_1_2_12_3_1","volume-title":"AANP statement on new HHS guidelines to treating opioid use disorder","author":"American Academy of Nurse Practitioners","year":"2021"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108715"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000863"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12307"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.00859"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa062"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2014.08.008"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000908"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.focus.17206"},{"key":"e_1_2_12_12_1","volume-title":"National drug overdose deaths 1999\u20132019","author":"Center for Disease Control","year":"2019"},{"key":"e_1_2_12_13_1","unstructured":"Clemena\u2010Cope L. 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