State licensing laws bar treatment of opioid addiction, especially in areas that lack doctors

State laws prevent nurse practitioners and physician assistants from using a federal license to prescribe potentially life-saving medicine for opioid addiction, Christine Vestal reports for Stateline. Earlier this month two federal agencies—Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration—"gave more than 700 nurse practitioners and physician assistants the authority to write prescriptions for the anti-addiction medication buprenorphine."

But 28 states "prohibit nurse practitioners from prescribing buprenorphine unless they are working in collaboration with a doctor who also has a federal license to prescribe it," Vestal writes. The problem is that half of all counties in the U.S., mainly in rural areas, "do not have a single physician with a license to prescribe buprenorphine." (Stateline map: Barriers for nurse practitioners to prescribe treatment for opioid addiction)

Oklahoma, Tennessee and Wyoming have laws that "explicitly prohibit nurse practitioners from prescribing buprenorphine—one of three anti-addiction medications approved by the U.S. Food and Drug Administration—with or without a doctor’s supervision," Vestal notes. A law in Kentucky prohibits physician assistants from prescribing it.

In the 15 years since doctors have been allowed to prescribe buprenorphine, fewer than 39,000 have sought a license to do so, Vestal writes. Overall, there are "more than 222,000 nurse practitioners and about 109,000 physician assistants in the nation, and many of them offer primary health care in rural parts of the nation where the opioid crisis is most acute."