¶ … Drug Addiction Treatment Act of 2000 certainly had noble intentions and safeguards. Indeed, there is a definitive reason why physicians are allowed a certain set of rights and responsibilities and why nurse practitioners are just a little further down the ladder in terms of rights and options. To be sure, anything related to opiates is something that should be regulated very highly as the ability and opportunity to abuse the rights to prescribe these drugs is prevalent and hard to miss. However, also hard to miss is the rampant amount of abuse and addiction that has been rendered and this problem is aggravated by the fact that drugs containing buprenorphine are restricted to physicians only despite the immeasurable benefit that could be rendered to addicted persons. While restricting such drugs is not a terrible idea, it is not the best idea with buprenorphine because of the amount of addicted and untreated people in question and this report will shall use scholarly and peer-reviewed research to make the point as to why this needs to change.
Literature Review
The author of this report found four articles that specifically address and assail the restriction of nurse practitioners. To put a fine point on the problem, the nurse practitioners that see the need to prescribe buprenorphine cannot do so and many of the physicians that can actually dispense the medication seem to choose not to do so. This is especially vexing as buprenorphine-laden drugs were specifically approved and designed for out-patient use which is something that is a bit rare with people saddled with an opioid addiction. The reason physicians are not prescribing is likely related to the fact that it is indeed done on an outpatient basis and perhaps they feel that such an approach is not wise or effective for opiate addiction. In addition, physicians that monitor nurse practitioners that have the right to prescribe medication are specifically prohibited from delegating the prescribing of buprenorphine-laden drugs. This combination is no doubt aggravating the fact that so many people, about 1.2 million in 2005, are addicted to opiates but only about a fifth of those people are getting treatment. This means that nearly a million people, and this was in 2005, are not getting drug treatment they could get much easier if physicians would actually use the drugs or at least be given the option to delegate the ability to nurse practitioners. Perhaps there is some valid concern in treating opiate addiction on an outpatient basis. Indeed, some people simply cannot or will not get clean unless they enter a full-fledged rehabilitation program. However, if more people could get treatment, even if in-patient is the better course, then the choice to allow for more prescription of buprenorphine would seem to be the better course regardless of how it comes about. Unfortunately, the DATA law is very explicit in that it says that any person that prescribes buprenorphine has to be a "physician that is licensed under state law" (Fornili & Burda, 2009).
One solution to perhaps making a change to the DATA restriction relative to buprenorphine without being careless is using the Geelhoed-Schouwstra Framework (GSF). It is a rational problem-solving schematic which allows for a policy evaluation process to be undertaken and completed before any rash or major changes are made. Part of such a framework would be information collection and exactly that has been attempted on many occasions. Indeed, many of the physicians who were contacted about their use (or non-use) of buprenorphine said that they either don't use it or "don't treat addicts" in general. However, a very telling and damning statistic is that nearly nine out of ten physicians assailed the reimbursement rates as the (or at least one of the) main reasons why they did not prescribe the drug more often. This is despite the fact that the same number of physicians were given the purview and option to use the buprenorphine drugs as they wished. At the same time, only about ten percent actually did so. The head-scratching part is that while the DATA specifically forbids delegation to nurse practitioners (the "what"), there is no "why" given as to why buprenorphine is restricted from use for nurse practitioners and/or the doctors that want to give their nurse practitioners supervisees the ability to do so. It begs the question why the legislation levies these requirements but does not explain or justify why nurse practitioners can prescribe other drugs under the supervision...
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