For Nurse Practitioners: Integrating MOUD into Primary and Other Care Settings

NPs in primary care, family practices, community health centers, and other non-specialty settings — who often see their patients on a more frequent basis — can play a critical role in diagnosing and treating SUD and providing the support necessary for people to achieve their recovery goals. Chances are, you are already treating patients with other chronic illness in your practice who would benefit from these essential services.

There are various pathways to recovery. The use of Food and Drug Administration (FDA)-approved medications for opioid use disorder (MOUD), including buprenorphine, methadone, and naltrexone, is one component of an evidence-based care plan that also includes counseling, behavioral therapies, and medical and social services to best meet the needs of each individual.

Integrating MOUD into Your Practice

Explore and identify the MOUD protocols and processes that best suit your type of practice. Tailor them to meet the unique needs of your patients and save lives.

With the elimination of the DATA-Waiver (X-Waiver), where state law allows, practitioners (physicians, PAs, and NPs) in a variety of care settings who hold a Drug Enforcement Administration (DEA) registration with Schedule II-V authority can now prescribe buprenorphine for the treatment of OUD without a special waiver and integrate these evidence-based services into their practices.

To effectively integrate MOUD into your practice, it is crucial to understand and address common barriers and misconceptions that may get in the way of treating patients with SUD. The following table summarizes these barriers and provides approaches to overcome them, ensuring that all of your patients receive nonjudgmental responsive care.

The Agency for Health Care Research and Quality (AHRQ), through its Integration Academy, developed the Medications for Opioid Use Disorder Playbook as a practical guide for providing MOUD and immediate care for patients with OUD in primary care and other ambulatory care settings.

This interactive, web-based product has the latest guidance, tools, resources, tips, and examples that address key aspects of MOUD implementation. The Playbook will help you find your own path for implementation by applying knowledge about successful approaches and navigating possible barriers.

Getting Started

All licensed practitioners who hold a Drug Enforcement Administration (DEA) registration with Schedule II–V authority, and where state law allows, can now prescribe buprenorphine.

To prescribe, you must meet one of the following requirements:

• Complete eight hours of training on OUD or SUD

  Or

• Have graduated in good standing within the past five years from a nurse practitioner school in the United States; this matriculation should include successful completion of an OUD or SUD curriculum.

Visit Training Requirements (MATE Act) Resources for more information about training and how to attest to these requirements when applying for a new or renewed DEA registration.

If you have questions about requirements in your state, contact your state licensing board or local DEA office.

Continuing Education

• For continuing education activities, visit the American Association for Nurse Practitioners (AANP) CE Opportunities webpage.
• One particularly important opportunity is the AANP’s Addressing Substance Use Disorders in Primary Care Bundle. This multi-module series allows learners to select the modules that they want to complete in any order that they want to complete them in. CE/Rx credit and a completion certificate are awarded for each module that is completed.