Report: Physician’s assistants, nurse practitioners cite lack of training in getting DEA waiver

Report: Physician’s assistants, nurse practitioners cite lack of training in getting DEA waiver

Physician’s assistants and nurse practitioners say lack of training is the number one reason they don’t apply for waivers from the DEA to be able to prescribe medication-assisted treatment of addiction, according to a new report.

Published by the American Academy of Physician’s Assistants, the study found that nearly two-thirds of the PAs the organization surveyed cited lack of training as the main barrier to getting the waiver. Other barriers to PAs and NPs getting the DEA waiver included lack of available mental health or psychosocial services (55.1 percent) and time constraints (54 percent).

Waivers are required for any physician, physician assistant, and nurse practitioner who treats patients suffering from substance use disorder or opioid use disorder through medication-assisted treatments.

Three drugs – buprenorphine, methadone, and naltrexone – are approved by the U.S. Food and Drug Administration to that treatment, but they require a waiver from the DEA to be able to prescribe them. In 2016, the U.S. Health and Human Services Department decided to extend that waiver to PAs and NPs who wished to prescribe buprenorphine, provided they undergo 24 hours of training.

In order to qualify as a MAT prescriber, the PAs or NPs must also be licensed in their state to prescribe Schedule III, IV or V medications for pain; have demonstrated ability to treat and manage opioid use disorder patients; and be supervised or work in collaboration with a qualifying physician.

But in 2019, the AAPA asked PAs whether they have that waiver, what barriers they faced in getting the waiver, and how much competency they have in their ability to diagnose, treat and manage SUD. Of the group surveyed, only 7.5 percent, or 5,083 individuals, responded that they had the waiver.

To address that, the AAPA, in collaboration with the American Academy of Nurse Practitioners and the American Society for Addiction Medicine, said that they would provide the mandatory 24-hour waiver training for both PAs and NPs.

“AAPA, in conjunction with other organizations, continues to look for ways to help PAs combat OUD. By understanding the needs of PAs trying to obtain MAT waivers and their resistance to them, AAPA, Physician Assistant Education Association, and other community partners can strengthen their OUD education, support, and lobbying. With opioid use disorders affecting large portions of the population, it is imperative that more PAs be able to recognize and treat this disorder,” the report said.