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Discussion

MAT program

I am a acute care nurse practitioner who has been offered a job to join a program that helps people with drug addiction (opioids). It is an outpatient clinic that has several physicians and NP who are waivered to treat opioid addiction with Buprenorphine and naltrexone. Would a acute care nurse practitioner be out of her scope of practice to work in the clinic?

Featured Replies

An AG Primary Care NP or FNP can indeed perform MAT. A PMHNP is not required. This does require obtaining an x-waiver, which generally requires 24 hours of online training. I am a member of the MAT program at my primary care clinic. As for an Acute Care NP, I don't know. The OP might want to call her state NP association for some guidance.

On 4/6/2019 at 8:05 AM, djmatte said:

ACNP should be working in acute settings which long term out patient drug rehab is not.

This is not true and reflects a gross (although unfortunately not uncommon) misunderstanding of the Consensus Model and NP Scope of Practice which makes the distinction on patient population and not setting. Aside from state-specific issues, ACNPs should be focused on adults who are acutely ill +/- chronically complicated. I would say detox would be appropriate but an outpatient clinic would depend a great deal on how much collaboration their is with mental health providers. If the position is to provide ongoing care for chronic substance abuse patients in lieu of a mental provider, then that would not be appropriate. But if the position is to manage medically complex patients, treat primarily their physical symptoms, and mental health providers are also involved in their care, then it would likely be appropriate. Overall, the most important consideration is that the provider (OP in this case) has training and experience in the care being provided which could include OTJ training/supervision.

As a PMHNP, and yes I got my degree some 15 years ago, we had a laughable hour of training in addiction. If that?

I don't remember any, truth be told.

The role has expanded since I went to school, and now includes children, so I doubt the addiction part has received any more emphasis.

I have a DATA 2000 waiver. It was easy to get and interesting. I haven't prescribed buprenorphine yet because of the log jam re-credentialing process at my employer. Also, the nurse board makes it a burden so I'm thinking about surrendering the waiver. I'm not terribly interested in addictions anyway.

Conversely, since Jan. 1, I've probably prescribed my weight in naltrexone tablets and a score of injections as well. No waiver or special qualifications required.

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