Saturday February 24th 2018

ANA partners to address a challenging public health problem

Lisa Summers

“Opioid abuse is a national issue that has touched families from all demographics. It is a complex problem that is going to require collaborative effort on many levels to address,” said Martha Carter, DHSc, MBA, APRN, CNM, chief executive officer of FamilyCare Health Centers in Charleston, WV, and a West Virginia Nurses Association member, the day before President Barack Obama arrived in her state to announce a series of initiatives to address opioid drug-related overdoses and deaths.

Prescription drugs, particularly opioid analgesics, have increasingly been identified as the leading cause of deaths due to drug overdose, and drug overdose is now the leading cause of injury death in the United States. And while opioid medications can be very effective in relieving pain when prescribed for the right condition and when used properly, the Department of Health and Human Services has made addressing the problem of opioid abuse a high priority. In addition, the American Nurses Association has joined with more than 40 provider groups in a commitment to target three priority areas:

1) Opioid prescribing practices;

2) Expanded use of naloxone; and

3) Expansion of medication-assisted treatment to reduce opioid use disorders and overdoses.

These three priorities were selected from a wide variety of possible interventions because evidence shows that they have the highest likelihood of producing clinically meaningful outcomes. And nurses, particularly advanced practice registered nurses, have an important role to play.

In “Translating Evidence into Action,” the HHS plan includes working with states and prescribers to increase utilization of Prescription Drug Monitoring Programs, with a specific goal to double the number of health care providers registered with their PDMP in the next two years. These programs are state-run electronic databases that can provide a prescriber or pharmacist with information regarding a patient’s prescription history, allowing the identification of patients who are potentially abusing medications. ANA will work with its constituent/state nurses associations to increase awareness of PDMPs and increase the number of APRN prescribers who are registered.

The HHS plan includes the identification of barriers to medication-assisted treatment for opioid use disorders and development of action plans to address these barriers. One of the barriers identified by APRNs is the limitation on prescribing buprenorphine and naloxone (Suboxone) outside of treatment facilities. The Drug Addiction Treatment Act of 2000 (DATA 2000) allowed physicians to apply for a waiver to prescribe narcotic drugs for maintenance or detoxification treatment. ANA has supported efforts to expand the waiver program to add APRNs to the definition of “qualified practitioner.”

Awareness campaigns are an important component of the plan to address the prescription drug and heroin abuse problems. A broad public awareness campaign has engaged major news outlets, as well as sports leagues; student athletes will be reached by campaigns that include coaches and athletic trainers, as well as the National Collegiate Athletic Association; and provider groups are on board to reach more than 4 million health care providers with awareness messaging on opioid abuse, appropriate prescribing practices, and actions providers can take to be a part of the solution in the next two years. Nurses, who represent the largest single group of health care providers, are critical to the success of this initiative. ANA looks forward to working with HHS and other nursing organizations to end this public health problem.

— Lisa Summers is the senior policy fellow in Health Policy at ANA.

Resources

HHS/ASPE Issue Brief:
“Opioid Abuse in the U.S. and HHS Actions to Address Opioid-Drug Related Overdoses and Deaths”
http://aspe.hhs.gov/basic-report/opioid-abuse-us-and-hhs-actions-address-opioid-drug-related-overdoses-and-deaths

2015 NCSBN APRN Roundtable materials:
www.ncsbn.org/6692.htm

ANA Issue Brief:
www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs

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