Explaining the New DEA Rule: APRNs & Prescribing for Opioid Disorders
Tuesday, February 27, 2018
Posted by: Erin Cusack
Explaining the New DEA Rule
On January 23, 2018, a final rule was released by the Drug Enforcement Administration (DEA) allowing nurse practitioners to prescribe and dispense FDA-approved, buprenorphine-containing medications for treating opioid use disorders. This DEA rule was required under the Comprehensive Addiction and Recovery Act (CARA) of 2016, which expanded the categories of practitioners who could dispense a narcotic drug for addiction treatment.
In order to qualify, the NP or PA must satisfy each of the following criteria:
- Should be licensed under State law to prescribe schedule III, IV, or V medications for the treatment of pain;
- Must complete not fewer than 24 hours of initial training (see more below); and
- Is supervised by, or works in collaboration with a qualifying physician, if the NP or PA is required by State law to prescribe medications for the treatment of opioid use disorder in collaboration with or under supervision of a physician.
How Do CARA & the New DEA Rule Impact NP Practice?
Prior to the recent changes made by CARA, APRNs could not prescribe buprenorphine because they were not eligible to obtain the DEA-X number. In addition to the regular DEA number, the provider who prescribes buprenorphine has to obtain a second DEA number specific to substances such as buprenorphine.
Previously, federal law permitted the DEA-X numbers to be issued to physicians only. The recent changes to federal law allow NPs and PAs to be issued these numbers as well for a limited number of patients.
More on Required Training and Waivers
In order to begin prescribing for opioid disorders, APRNs will need to complete certain training and obtain a federal waiver. In order to qualify for the waiver, NPs and PAs must complete 24 hours of education, which can be provided through the American Association of Nurse Practitioners free of charge. NPs and PAs who have completed the 24 hours of required training may then seek to obtain a DATA 2000 waiver for up to 30 patients by completing the Waiver Notification Form available here.