Members discuss treatment options for opioid use disorder, nursing recruitment & retention, and ARPA funding for health initiatives.
Expanding Office-based Opioid Use Disorder Treatment to Save Lives
Frances McGaffey and Glenn Wright from the Pew Charitable Trusts gave an overview of office based opioid disorder treatment. In short, there were over 80,000 opioid overdoses in the 12 months ending January 2022. One of the most important things we can do to prevent these deaths is improve access to and use of medications for opioid use disorder.
According to the National Academies, medications for opioid use disorder save lives. Right now there are three medications approved by the FDA: methadone, buprenorphine, and naltrexone. Evidence shows that using these medications, especially methadone and buprenorphine, can reduce a person’s risk of overdose. But according to federal data, only 11% of people with OUD received one of these medications in 2020 and research has demonstrated that people of color are especially at risk for not receiving these life-saving medications.
F. McGaffey focused most of the presentation on buprenorphine. Buprenorphine is a highly effective medication and could be made available in many places people already receive care, like community health centers and mental health clinics because it doesn’t need to be delivered in a specialized facility. Anyone operating within their state’s scope of practice laws can provide it, as long as they have a DEA license.
A recent change to federal policy means that any provider who meets those criteria – doctors, nurse practitioners, physician assistance – can treat up to 30 patients just by notifying the Substance Abuse and Mental Health Services Administration that they intend to do so. If they want to serve more patients, they need additional training. Once they complete that training, they’ll have a “waiver” to prescribe buprenorphine.
It’s worth mentioning that these training requirements could be removed if Congress passes the MAT act – which has passed the house and is waiting for action in the Senate.
F. McGaffey concluded the presentation by comparing data from Colorado, Missouri, and Washington. Full data can be accessed in the “Resources” section.
- Medications for Opioid Use Disorder Improve Patient Outcomes – A review of the medications
- Policies Should Promote Access to Buprenorphine for Opioid Use Disorder – A discussion of policy options for low-barrier treatment
- State Policy Changes Could Increase Access to Opioid Treatment via Telehealth
- Presenter PowerPoint
The Pew Charitable Trusts
Associate Manager, Substance Use
Prevention and Treatment Initiative
The Pew Charitable Trusts
Recruitment and Retention of Nursing Professionals and Nursing Faculty
Recruitment and retention of nursing professionals is complex and mostly due to lack of teaching faculty and the lucrative travel nurse programs.
Senator Tom Begich led a conversation regarding the nursing shortage. He emphasized that the shortage of nursing was not due to a lack of willing candidates or nursing programs; rather, there are not enough faculty to teach. It is far more lucrative to practice nursing than it is to teach it.
Dori Healy, Clinical Nurse Specialist, St. Luke’s Health System; Adjunct Professor, Idaho State University, remarked that the small bump in salary from adjunct professor to professor was not worth the burdensome workload. According to her, there is no incentive to ascend in academia, save a love of teaching. Attendees agreed that this is a concerning trend and will start thinking of ways to bridge this gap.
Some members expressed concern that traveling nurses are partly to blame for retention issues. The pay for traveling nurses is markedly higher than a standard nurse. Jason Richie, Associate Director, State Policy, American Nurses Association, informed the group that traveling nurse agencies can take up to 30% of the cut.
Update on Usage of ARPA Funding for Health Initiatives
- COVID has put a magnifying glass up to the issue of Mental Health. Many states are allocating ARPA funds to address mental health as it pertains to the workforce, juveniles, and the homeless.
- “You can’t address mental health without putting in mental health dollars.”
Representative Laurie Lickley (ID) was invited to present at a Route 50 Webinar. Though she was ultimately unable to attend, she gave an overview of her prepared remarks regarding mental health initiatives in the state of Idaho.
Assemblymember Mike Gipson (CA) added that in California, a significant amount of funds have been allotted to mental health and the legislature is actively finding ways to combat mental health issues in the homeless population.
Senator Tom Begich reported that Alaska is approaching use of ARPA funds in a similar manner. He emphasized that use of the funding is guided by the fact that this is one-time funding. Alaska is being conscientious about spending the money on short-term projects rather than creating programs that will require ongoing funding.