Impact of Nurse Practitioner Scope of Practice on Treatment for Chronic Pain and Opioid Use Disorder: A Scoping Review

Identifying barriers and facilitators for nurse practitioners' opioid management of chronic pain

“…Currently, in the United States and its territories, NPs in 27 locations have full practice authority, those in 17 locations have reduced prescriptive authority, and NPs in 11 locations have restricted prescriptive authority (American Association of Nurse Practitioners, 2021). Nikpour and Broome (2021) reported that NPs viewed limitations on their scope of practice and prescriptive authority as a major barrier to managing chronic pain (Nikpour & Broome, 2021). Additionally, based on the themes observed in the reviewed articles, limited authority is still the predominant issue faced by NPs, especially for opioid prescription.…”

“…The authors examined the impacts of state-level restrictions on patient access to effective pain management and concluded that legal limitations on NPs' scope of practice and prescriptive authority constituted a major barrier to managing chronic pain. Their findings suggested that NP scope of practice limitations had not achieved the joint goals of managing chronic pain while combatting the opioid epidemic (Nikpour & Broome, 2021). Although their review was useful in identifying legal restrictions that prevent NPs from treating chronic pain as well as opioid use disorder, the practical barriers, facilitators, and other factors influencing NPs' opioid management in the clinical setting were not comprehensively examined.…”

Opioid Use Disorder Practice by Licensure Category in North Carolina

“…A shortage or perceived lack of support from fellow providers has also been cited as a known barrier to APPs treating OUD [8,9]. For states in which APPs are required to be supervised, such as North Carolina, waivered APPs seeking to prescribe buprenorphine are currently required by federal law to be supervised by a waivered physician.…”