{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:20:05Z","timestamp":1777940405534,"version":"3.51.4"},"reference-count":68,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,12,6]],"date-time":"2020-12-06T00:00:00Z","timestamp":1607212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Policy, Politics, &amp; Nursing Practice"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>In October 2018, President Trump signed into law H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. This piece of legislation addresses treatment, prevention, recovery, and enforcement with particular attention to access in rural areas. It contains numerous provisions to improve needed access to treat substance use disorders and especially opioid use disorder (OUD), including mandatory coverage of medications for OUD, partial elimination of Medicaid payment for inpatient mental health treatment, and state planning grants to increase provider capacity. Many of these provisions would be significantly enhanced by removing barriers to prescriptive authority for Advanced Practice Registered Nurses (APRNs), including Nurse Practitioners, Clinical Nurse Specialists, Certified Nurse Midwives, Certified Registered Nurse Anesthetists, and other state-specific titles for nurses whose scope allows the prescription of controlled substances. This policy brief includes a history of the role of APRNs in the delivery of medications for OUD, scope of practice restrictions related to prescriptive authority as a barrier in their ability to deliver care for this vulnerable population, and actionable strategies that APRNs can take to advocate for an increased role in providing care.<\/jats:p>","DOI":"10.1177\/1527154420978720","type":"journal-article","created":{"date-parts":[[2020,12,6]],"date-time":"2020-12-06T06:07:32Z","timestamp":1607234852000},"page":"85-92","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["States Should Remove Barriers to Advanced Practice Registered Nurse Prescriptive Authority to Increase Access to Treatment for Opioid Use Disorder"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0035-6301","authenticated-orcid":false,"given":"Hayley D.","family":"Germack","sequence":"first","affiliation":[{"name":"Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,12,6]]},"reference":[{"key":"bibr1-1527154420978720","unstructured":"AB-890 Nurse practitioners: Scope of practice: Practice without standardized procedures. (2020). https:\/\/leginfo.legislature.ca.gov\/faces\/billTextClient.xhtml?bill_id=201920200AB890"},{"key":"bibr2-1527154420978720","doi-asserted-by":"publisher","DOI":"10.7326\/M20-1141"},{"key":"bibr3-1527154420978720","unstructured":"Altarum. (2018).\n                      Economic toll of opioid crisis in U.S. exceeded $1 trillion since 2001\n                      . https:\/\/altarum.org\/news\/economic-toll-opioid-crisis-us-exceeded-1-trillion-2001"},{"key":"bibr4-1527154420978720","unstructured":"American Association of Nurse Practitioners. (2020a, November 4).\n                      COVID-19 state emergency response: Temporarily suspended and waived practice agreement requirements.\n                      https:\/\/www.aanp.org\/advocacy\/state\/covid-19-state-emergency-response-temporarily-suspended-and-waived-practice-agreement-requirements"},{"key":"bibr5-1527154420978720","unstructured":"American Association of Nurse Practitioners. (2020b).\n                      Nurse practitioner prescriptive authority\n                      . https:\/\/www.aanp.org\/advocacy\/advocacy-resource\/position-statements\/nurse-practitioner-prescriptive-privilege"},{"key":"bibr6-1527154420978720","unstructured":"American Association of Nurse Practitioners. (2020c).\n                      NP fact sheet\n                      . https:\/\/www.aanp.org\/about\/all-about-nps\/np-fact-sheet"},{"key":"bibr7-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.02.006"},{"key":"bibr8-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12307"},{"key":"bibr9-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.01.004"},{"key":"bibr10-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1177\/1077558718793070"},{"key":"bibr11-1527154420978720","unstructured":"Assembly Bill No. 890, 890, California Legislature. (2019). leginfo.legislature.ca.gov\/faces\/billNavClient.xhtml?bill_id=201920200AB890"},{"key":"bibr12-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1177\/1077558716649109"},{"key":"bibr13-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.1158"},{"key":"bibr14-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.00859"},{"key":"bibr15-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2014.08.008"},{"key":"bibr16-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/S2155-8256(19)30081-X"},{"issue":"2","key":"bibr17-1527154420978720","first-page":"210","volume":"63","author":"Comer S. D.","year":"2006","journal-title":"JAMA Psychiatry"},{"key":"bibr500-1527154420978720","unstructured":"Comprehensive Addiction and Recovery Act of 2016, P.L. 114-198, 524 Stat. (2016)."},{"key":"bibr18-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000075"},{"key":"bibr19-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2019.1572052"},{"key":"bibr20-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000135"},{"key":"bibr21-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1097\/JAN.0000000000000160"},{"key":"bibr23-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2007.02090.x"},{"key":"bibr24-1527154420978720","unstructured":"Hancock C., Mennenga H., King N., Andrilla H., Larson E. B., Schou P. (2017).\n                      Treating the rural opioid epidemic.\n                      https:\/\/www.ruralhealthweb.org\/NRHA\/media\/Emerge_NRHA\/Advocacy\/Policy%20documents\/Treating-the-Rural-Opioid-Epidemic_Feb-2017_NRHA-Policy-Paper.pdf"},{"key":"bibr25-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2017.04.005"},{"key":"bibr26-1527154420978720","unstructured":"Hussain P. L. (2020).\n                      Opioid use disorder education for student nurse practitioner\n                      . https:\/\/sigma.nursingrepository.org\/handle\/10755\/20884"},{"key":"bibr27-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1595"},{"key":"bibr28-1527154420978720","author":"Institute of Medicine","year":"2011","journal-title":"The National Academies Press"},{"key":"bibr29-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1992.03480200058024"},{"key":"bibr30-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1111\/add.14436"},{"key":"bibr31-1527154420978720","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302664"},{"key":"bibr32-1527154420978720","unstructured":"Klivans L. (2019).\n                      Could expanding nurse\u2019s scope of care help fight the opioid epidemic in California?\n                      https:\/\/www.kqed.org\/news\/11743543\/could-expanding-nurses-scope-of-care-help-fight-the-opioid-epidemic-in-california"},{"key":"bibr33-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60358-9"},{"key":"bibr34-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2018.11.001"},{"issue":"19","key":"bibr35-1527154420978720","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss6619a1","volume":"66","author":"Mack K. A.","year":"2017","journal-title":"MMWR Surveillance Summaries 2017"},{"key":"bibr36-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1177\/1078390318811570"},{"key":"bibr37-1527154420978720","unstructured":"Maier S. (2019, April 9).\n                      Many nurse practitioners cannot provide medications to treat opioid addiction\n                      . https:\/\/www.ucsf.edu\/news\/2019\/04\/413856\/many-nurse-practitioners-cannot-provide-medications-treat-opioid-addiction"},{"key":"bibr38-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002209.pub2"},{"key":"bibr39-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001333.pub3"},{"key":"bibr506-1527154420978720","unstructured":"Modernization of the Professional Nursing Law, S.B. 25, Pennsylvania General Assembly. (2019). https:\/\/www.legis.state.pa.us\/CFDOCS\/Legis\/PN\/Public\/btCheck.cfm?txtType=PDF&sessYr=2019&sessInd=0&billBody=S&billTyp=B&billNbr=0025&pn=0507"},{"key":"bibr40-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/j.hjdsi.2014.09.009"},{"key":"bibr41-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001126"},{"key":"bibr42-1527154420978720","doi-asserted-by":"crossref","unstructured":"National Academies of Sciences Engineering and Medicine. (2019).\n                      Medications for opioid use disorder save lives\n                      . The National Academies Press. https:\/\/doi.org\/10.17226\/25310","DOI":"10.17226\/25310"},{"key":"bibr43-1527154420978720","unstructured":"National Council of State Boards of Nursing. (2018). APRN consensus. https:\/\/www.ncsbn.org\/5397.htm"},{"key":"bibr44-1527154420978720","unstructured":"National Institute of Drug Abuse. (2020). Pennsylvania: Opioid-involved deaths and related harms. https:\/\/www.drugabuse.gov\/opioid-summaries-by-state\/pennsylvania-opioid-involved-deaths-related-harms"},{"key":"bibr45-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2008.06.006"},{"key":"bibr46-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.2147"},{"key":"bibr47-1527154420978720","doi-asserted-by":"publisher","DOI":"10.3928\/01484834-20200323-12"},{"key":"bibr48-1527154420978720","unstructured":"Penn A. (2019, June 25).\n                      It\u2019s time to question the restrictions on buprenorphine.\n                      https:\/\/www.psychcongress.com\/article\/its-time-question-restrictions-buprenorphine"},{"key":"bibr49-1527154420978720","unstructured":"Pew Charitable Trusts. (2019). Nurse licensing laws block treatment for opioid addiction. https:\/\/www.pewtrusts.org\/en\/research-and-analysis\/blogs\/stateline\/2017\/04\/21\/nurse-licensing-laws-block-treatment-for-opioid-addiction"},{"key":"bibr50-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1111\/add.13193"},{"key":"bibr51-1527154420978720","unstructured":"Rex S. A. (2018, September 5).\n                      Pa. lawmakers should reject proposals to change nurse practitioner requirements\n                      . https:\/\/www.mcall.com\/opinion\/mc-opi-nurse-practitioner-legislation-20180905-story.html"},{"key":"bibr52-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2017.06.009"},{"key":"bibr54-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1604339"},{"key":"bibr55-1527154420978720","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301049"},{"key":"bibr56-1527154420978720","unstructured":"Scope of Practice Policy. (2019).\n                      California scope of practice policy: State profile\n                      . http:\/\/scopeofpracticepolicy.org\/states\/ca\/"},{"key":"bibr58-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.0834"},{"key":"bibr59-1527154420978720","unstructured":"Substance Abuse and Mental Health Services Administration. (2019a).\n                      Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug use and Health\n                      (NSDUH Series H-54, Issue). https:\/\/www.samhsa.gov\/data\/"},{"key":"bibr60-1527154420978720","unstructured":"Substance Abuse and Mental Health Services Administration. (2019b). Medication-assisted treatment of opioid use disorder. https:\/\/store.samhsa.gov\/system\/files\/sma16-4892pg.pdf"},{"key":"bibr61-1527154420978720","unstructured":"Substance Abuse and Mental Health Services Administration. (2020a).\n                      COVID-19 public health emergency response and 42 CFR part 2 guidance\n                      . https:\/\/www.samhsa.gov\/sites\/default\/files\/covid-19-42-cfr-part-2-guidance-03192020.pdf"},{"key":"bibr62-1527154420978720","unstructured":"Substance Abuse and Mental Health Services Administration. (2020b). Opioid treatment program (OTP) guidance. https:\/\/www.samhsa.gov\/sites\/default\/files\/otp-guidance-20200316.pdf"},{"key":"bibr63-1527154420978720","unstructured":"SUPPORT for Patients and Communities Act. (2018). https:\/\/www.congress.gov\/bill\/115th-congress\/house-bill\/6"},{"key":"bibr64-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201300256"},{"key":"bibr65-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2015.1101733"},{"key":"bibr66-1527154420978720","unstructured":"University of Michigan Behavioral Health Workforce Research Center. (2018).\n                      Mapping supply of the\n                      U\n                      .S. psychiatric workforce\n                      . http:\/\/www.behavioralhealthworkforce.org\/wp-content\/uploads\/2019\/01\/Y3-FA1-P2-Psych-Mapping-Full-Report-with-Appendix.pdf"},{"key":"bibr67-1527154420978720","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6709e1"},{"key":"bibr68-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-008-0686-x"},{"key":"bibr69-1527154420978720","doi-asserted-by":"publisher","DOI":"10.1016\/S2155-8256(17)30176-X"}],"container-title":["Policy, Politics, &amp; Nursing Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1527154420978720","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1527154420978720","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1527154420978720","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:48:41Z","timestamp":1777700921000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1527154420978720"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,6]]},"references-count":68,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1177\/1527154420978720"],"URL":"https:\/\/doi.org\/10.1177\/1527154420978720","relation":{},"ISSN":["1527-1544","1552-7468"],"issn-type":[{"value":"1527-1544","type":"print"},{"value":"1552-7468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,6]]}}}