Wiggins Morgan, Smith Amy, Helsabeck Nathan
Morgan Wiggins, DNP, APRN, PMHNP-BC, The Ohio State University, Columbus, OH, USA.
Amy Smith, DNP, MSW, APRN, PMHNP-BC, FNP-BC, The Ohio State University, Columbus, OH, USA.
J Am Psychiatr Nurses Assoc. 2025 Jun;31(3):259-266. doi: 10.1177/10783903241271273. Epub 2024 Aug 18.
Alcohol use disorder (AUD) is common and deadly. Naltrexone is a treatment for AUD. Previous research examined factors that predict Ohio Advanced Practice Registered Nurses' (APRNs) utilization of naltrexone to treat AUD. Inclusion criteria included APRNs' endorsing receipt of the X-waiver, a designation indicating providers' receipt of substance use disorder education. In 2023, the X-waiver was eliminated. The purpose of this study was to replicate the previous research design in respondents without an X-waiver and compare findings.
The aims of this study were three-fold: (1) assess whether race, age, practice setting, years in practice, or work experience with an addiction specialist physician predicted prescription of naltrexone for AUD, (2) assess whether the goal of abstinence or reduced alcohol use as desired treatment affected the likelihood of naltrexone prescription for AUD, and (3) compare differences between the answers in the current respondent group without X-waiver and the previous study's X-waivered respondents.
All Ohio APRNs were sent surveys. Eighty-eight responses were included in analysis. Descriptive statistics, logistic regression, and chi-square results were reported.
Work experience with an addiction specialist physician was negatively associated with prescribing naltrexone for AUD. Respondents from the previous study of X-waivered APRNs were significantly more likely to prescribe naltrexone for reduced alcohol consumption as a treatment outcome than the respondents in this study.
The recent policy change eliminating the X-waiver provides important context for research, adding to the substance use disorder literature.
酒精使用障碍（AUD）很常见且具有致命性。纳曲酮是一种治疗AUD的药物。先前的研究考察了预测俄亥俄州高级实践注册护士（APRN）使用纳曲酮治疗AUD的因素。纳入标准包括APRN认可获得X豁免，这一指定表明提供者接受了物质使用障碍教育。2023年，X豁免被取消。本研究的目的是在没有X豁免的受访者中复制先前的研究设计并比较结果。
本研究的目的有三个方面：（1）评估种族、年龄、执业环境、执业年限或与成瘾专科医生的工作经验是否能预测纳曲酮用于治疗AUD的处方情况，（2）评估戒酒或减少饮酒作为期望治疗目标是否会影响纳曲酮用于治疗AUD的处方可能性，以及（3）比较当前无X豁免受访者组与先前研究中有X豁免受访者的答案差异。
向所有俄亥俄州的APRN发送调查问卷。88份回复纳入分析。报告了描述性统计、逻辑回归和卡方检验结果。
与成瘾专科医生的工作经验与开具纳曲酮治疗AUD呈负相关。先前对有X豁免的APRN的研究中的受访者比本研究中的受访者更有可能开具纳曲酮以减少酒精消费作为治疗结果。
最近取消X豁免的政策变化为研究提供了重要背景，丰富了物质使用障碍文献。
