Portman, Ayotte push for swift expansion of treatment options for opioid use disorder

U.S. Sens. Rob Portman (R-OH) and Kelly Ayotte (R-NH) on Thursday called for swift implementation of provisions of the Comprehensive Addiction Recovery Act (CARA) that aim to expand medication-assisted treatment (MAT).

In a letter to Substance Abuse and Mental Health Administration (SAMHSA) Administrator Kana Enomoto, Portman and Ayotte pushed for changes that would enable nurse practitioners (NPs) and physician assistants (PAs) to prescribe MAT to treat opioid use disorder.

“In the face of the nationwide opioid misuse and overdose epidemic, as many qualified providers as possible are required in order to treat patients who are struggling with an opioid use disorder,” the senators wrote. “That is why we urge SAMHSA to prioritize expediting the release of regulations, including those related to educational requirements, necessary in order to effectively implement the provisions of CARA that allow NPs and PAs to prescribe MAT.”

Section 303 of CARA gives NPs and PAs the ability to prescribe MAT for a period of five years. Due to a lack of guidance from SAMHSA, however, NPs and PAs are unclear about educational requirements needed to prescribe MAT, the senators wrote.

“For example, NPs and PAs are unsure if whether they take the current eight-hour course now, they will be able to count that toward the 24-hour requirement, so long as they have taken the course from one of the approved DATA 2000 organizations approved to provide this education,” Portman and Ayotte wrote. “Additionally, we have heard concerns related to uncertainty regarding how proscriptive SAMHSA will be in certifying new courses based on the new curriculum requirements detailed in the law. The named organizations are eager to develop approved training courses for NPs and PAs, but require adequate direction from SAMHSA in order to proceed.”