Two Promising Steps Toward Addressing the Opioid Epidemic

At a recent campus-wide opioid task force at Penn, one noted researcher and clinician pointed out a painful truth: “We know how to treat addiction; it’s the systems that aren’t responding to the need.”

Last week, the nation took two important steps to helping our systems respond to this public health crisis: the first-ever Surgeon General’s Report on Alcohol, Drugs, and Health, and an announcement that allows physician assistants (PAs) and nurse practitioners (NPs) to prescribe medication-assisted treatment.

The Surgeon General’s report, while not directly affecting any sector or budget, is a call to action that can galvanize not only the health care system but the larger community. In essence, it can begin to change the culture, attitudes, and practices that create barriers to implementing proven treatments. The Surgeon General’s 1964 Report on Smoking and Health sparked collective action that prevented more than eight million smoking-attributable deaths in the next half-century. We’ll have more to say about the latest Surgeon General’s report in a subsequent post.

More directly, policymakers have now expanded access to effective treatment of opioid misuse by including nurse practitioners and physician assistants as providers able to prescribe buprenorphine (once they receive the mandated 24 hours of training). Previously, only physicians were able to prescribe (even when NPs and PAs couldwere able to prescribe the opioids that are associated with many patients developing a substance use disorder). However, state law regarding independent or collaborative practice for NPs and PAs still applies.

In a recent blog post, LDI fellows Jeffrey Hom and Krisda Chaiyachati pointed out this and other policy “disconnects” stand in the way of delivering effective treatments for opioid misuse. In recent briefs, LDI and colleagues from CHERISH highlighted the cost-effectiveness of medication-assisted treatment, and successful models for integrating opioid treatment into primary care.

Last week, the nation began to connect the dots.