{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:09:36Z","timestamp":1785431376959,"version":"3.56.0"},"reference-count":23,"publisher":"North Carolina Institute of Medicine","issue":"3","license":[{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nurse practitioners, physician assistants, and certified nurse midwives, collectively known as advanced practice providers (APPs), are critical members of the opioid use disorder (OUD) treatment workforce. Few studies compare the OUD treatment practice patterns of APPs relative to physicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, we distributed a survey examining general substance use disorder (SUD) and OUD-specific treat\u00adment practices to all licensed physicians and APPs in North Carolina, resulting in a sample of 332 respondents. Respondents were asked about screening, referrals, and Drug Enforcement Administration (DEA) X-waiver status. Waivered providers were asked about prescribing buprenorphine. Differences in practice patterns by provider type were examined using descriptive statistics and chi-squared tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Practice patterns were similar between APPs and physicians; however, more APPs reported screening their patients for SUDs (83.3% versus 69.4%,\n                      <jats:italic>p<\/jats:italic>\n                      = .0045). Of the providers who were waivered to prescribe buprenorphine, APPs and physicians were equally likely to be currently prescribing buprenorphine (75.8% versus 77.1%,\n                      <jats:italic>p<\/jats:italic>\n                      = .8900).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"limitations\">\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>This was a descriptive cross-sectional study using self-report data from a purposive sample and may not be representative of all providers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results describe practice patterns for APPs and physicians and differences that may be reflective of regulations and therapeutic approaches. Similarities in obtaining an X-waiver and prescribing buprenorphine suggest that reducing restrictions on APPs may result in a larger treatment workforce.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.18043\/001c.74508","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T08:40:56Z","timestamp":1683103256000},"source":"Crossref","is-referenced-by-count":1,"title":["Opioid Use Disorder Practice by Licensure Category in North Carolina"],"prefix":"10.18043","volume":"84","author":[{"given":"Phillip M.","family":"Hughes","sequence":"first","affiliation":[{"name":"UNC Eshelman School of Pharmacy","department":["Division of Pharmaceutical Outcomes and Policy"]},{"id":[{"id":"https:\/\/ror.org\/031vnay14","id-type":"ROR","asserted-by":"publisher"}],"name":"Mountain Area Health Education Center","department":["University of North Carolina Health Sciences Division of Research"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chase","family":"Harless","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/031vnay14","id-type":"ROR","asserted-by":"publisher"}],"name":"Mountain Area Health Education Center","department":["University of North Carolina Health Sciences"]},{"id":[{"id":"https:\/\/ror.org\/05rfqv493","id-type":"ROR","asserted-by":"publisher"}],"name":"East Tennessee State University","department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Ramage","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/031vnay14","id-type":"ROR","asserted-by":"publisher"}],"name":"Mountain Area Health Education Center","department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carriedelle","family":"Fusco","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/031vnay14","id-type":"ROR","asserted-by":"publisher"}],"name":"Mountain Area Health Education Center","department":["Department of Family Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayla","family":"Ostrach","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine","department":["Family Medicine and Medical Anthropology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7507","published-online":{"date-parts":[[2023,5,3]]},"reference":[{"issue":"2","key":"ref1","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1111\/jrh.12404","article-title":"Prescribing practices of nurse practitioners and physician assistants waivered to prescribe buprenorphine and the barriers they experience prescribing buprenorphine","volume":"36","author":"C. Holly A. Andrilla","year":"2020","journal-title":"The Journal of Rural Health","ISSN":"https:\/\/id.crossref.org\/issn\/0890-765X","issn-type":"print"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1111\/1475-6773.12643","article-title":"Does the regulatory environment affect nurse practitioners\u2019 patterns of practice or quality of care in health centers?","volume":"52","author":"Ellen T. 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Chase Harless","year":"2022","journal-title":"Southern Medical Journal","ISSN":"https:\/\/id.crossref.org\/issn\/1541-8243","issn-type":"print"},{"issue":"4","key":"ref5","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1097\/adm.0000000000000762","article-title":"DEA disconnect leads to buprenorphine bottlenecks","volume":"15","author":"Bayla Ostrach","year":"2021","journal-title":"Journal of Addiction Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/1932-0620","issn-type":"print"},{"issue":"100082","key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcsop.2021.100082","article-title":"Rural community pharmacist willingness to dispense Suboxone\u00ae: a secret shopper investigation in South-Central Appalachia","volume":"4","author":"G. 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Roehler","year":"2020","journal-title":"Drug and Alcohol Dependence","ISSN":"https:\/\/id.crossref.org\/issn\/0376-8716","issn-type":"print"},{"issue":"1","key":"ref19","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1111\/jrh.12307","article-title":"Geographic distribution of providers with a DEA waiver to prescribe buprenorphine for the treatment of opioid use disorder: a 5-year update","volume":"35","author":"C. Holly A. Andrilla","year":"2019","journal-title":"The Journal of Rural Health","ISSN":"https:\/\/id.crossref.org\/issn\/0890-765X","issn-type":"print"},{"issue":"1","key":"ref20","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1111\/jrh.12538","article-title":"The geographic impact of buprenorphine expansion to nurse practitioner prescribers in Oregon","volume":"38","author":"Tracy A. Klein","year":"2022","journal-title":"The Journal of Rural Health","ISSN":"https:\/\/id.crossref.org\/issn\/0890-765X","issn-type":"print"},{"issue":"5","key":"ref21","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/j.nurpra.2019.01.005","article-title":"Nurse practitioners\u2019 pivotal role in ending the opioid epidemic","volume":"15","author":"Dorothy James Moore","year":"2019","journal-title":"The Journal for Nurse Practitioners","ISSN":"https:\/\/id.crossref.org\/issn\/1555-4155","issn-type":"print"},{"issue":"4","key":"ref22","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/S2155-8256(20)30176-9","article-title":"Impact of nurse practitioner scope of practice on treatment for chronic pain and opioid use disorder: a scoping review","volume":"11","author":"J. Nikpour","year":"2021","journal-title":"J Nurs Reg"},{"issue":"2","key":"ref23","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1177\/1527154420978720","article-title":"States should remove barriers to advanced practice registered nurse prescriptive authority to increase access to treatment for opioid use disorder","volume":"22","author":"Hayley D. 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