Increasing the Supply of Providers with a Drug Enforcement Agency Waiver to Treat Opioid Addiction in Rural America – Possible Effects of Permitting Physician Assistants and Nurse Practitioners to Prescribe Buprenorphine

Research center:
Lead researcher:
Project funded:
September 2016
Project completed:
October 2018

Statement of problem/hypothesis: The Drug Addiction Treatment Act of 2000 is a Federal law (Public Law 106-310) that allows physicians, and only specially trained and certified physicians, to prescribe buprenorphine, a scheduled narcotic, for treatment of opioid addiction. Buprenorphine provides patients with opioid use disorder an effective, office-based alternative to treatment in federally designated methadone maintenance clinics that are unavailable in most rural areas. To prescribe buprenorphine, physicians must complete a training course on the use of the drug and then apply for a DEA waiver. Physician assistants (PAs) and nurse practitioners (NPs) have not been eligible for waivers, even in states that allow them to prescribe scheduled narcotics. This study quantified the potential increase in the ability of rural providers to treat opioid use disorder with buprenorphine if waivers are available to PAs and NPs.