Which States Allow Nurse Practitioners to Prescribe Suboxone?

Nurse practitioners are newly allowed to prescribe buprenorphine (Suboxone) as part of the Comprehensive Addiction and Recovery Act signed into law by former President Obama. While the Act augments nurse practitioners' scope of practice from a federal standpoint, some states are more limiting in the freedoms they allow NPs. In which states can nurse practitioners actually prescribe Suboxone?

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According to the Comprehensive Addiction and Recovery Act, nurse practitioners may attain special permission to prescribe buprenorphine (Suboxone) to a small set of patients by completing 24 hours of mandatory training. State scope of practice laws however, ultimately control nurse practitioners' prescribing privileges and can make it difficult or even unlawful for NPs to practice to the full extent of this new Act.

In states where nurse practitioners are required to have physician supervision or collaboration in order to prescribe, this oversight requirement remains when it comes to prescribing buprenorphine (Suboxone). This is how prescribing the drug is regulated in 25 states - physician oversight requirements stand, and NPs who complete buprenorphine training can prescribe the medication provided that they also meet state physician oversight requirements.

Lawmakers in three states, Tennessee, Wyoming and Oklahoma, have regulated buprenorphine prescribing above and beyond their usual physician collaboration requirement, expressly prohibited NPs from prescribing buprenorphine (Suboxone) at all. 

In the 22 remaining states where nurse practitioners enjoy full practice authority, NPs are permitted to prescribe buprenorphine provided they follow federal guidelines for doing so. This includes the completion of 24 hours of training by an approved education provider. Nurse practitioners who compete the required training are allowed to prescribe buprenorphine (Suboxone) for up to 30 patients in the year following training. After this year-long period, NPs can apply for a waiver to prescribe the drug for up to 100 patients.

While the ability to prescribe buprenorphine (Suboxone) is a 'win' for the NP profession, state laws tamper the effect the Comprehensive Addiction and Recovery Act will have in everyday practice. 

Will you complete the education requirements in order to prescribe Suboxone for your patients?

 

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