Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, United States.
Policy Polit Nurs Pract. 2021 May;22(2):85-92. doi: 10.1177/1527154420978720. Epub 2020 Dec 6.
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.
2018 年 10 月，特朗普总统签署了 H.R. 6 号法案，即《物质使用障碍预防和促进患者及社区康复治疗法案》。该法案特别关注农村地区的可及性，从治疗、预防、康复和执法等方面进行了规定。法案包含了许多旨在改善治疗物质使用障碍，特别是阿片类药物使用障碍（OUD）的可及性的条款，包括强制覆盖 OUD 药物治疗、部分取消医疗补助对住院精神治疗的支付、以及州规划拨款以增加提供者的能力。如果消除了对包括执业护士、临床护理专家、执业护师、注册麻醉师和其他具有开处管制药物权限的特定州护士头衔的高级实践注册护士（APRNs）处方权的限制，其中许多条款将会得到显著增强。本政策简报包括 APRNs 在提供 OUD 药物治疗方面的作用历史、与处方权相关的实践范围限制，以及 APRNs 为争取在该脆弱人群的护理中发挥更大作用而可以采取的可行策略。
