House approves measure allowing nurses to prescribe opioid care

A measure to widely expand the number of healthcare providers legally allowed to prescribe medications used to treat individuals with opioid addiction in Tennessee has landed on the desk of Gov. Bill Lee. 

Tennessee, thus far, has been the only state in the nation that has barred nurse practitioners or physician assistance from providing medication-assisted treatment, or MAT, a first-line treatment for opioid addiction. 

Instead, only doctors have had the power to dispense MAT. Many patients have sought the medication in private clinics that accept cash only, at a cost often surpassing $500 per month for the daily dose of medication that stems cravings without causing a high. Advocates have said the medication has saved countless lives.

The Tennessee Primary Care Association and Neighborhood Health in Nashville have sought lawmakers help in changing prescribing laws for nearly two years. 

A recent spike in overdose deaths during the COVID-19 pandemic may finally have nudged lawmakers in the state’s House of Representatives into approving the bill on Wednesday. The state’s Senate has previously voted in favor of the measure.

Unemployment and economic uncertainty have proved challenging for patients reliant on the medication for their sobriety to continue to access private clinics. 

In Nashville, there were 107 overdose deaths between March 1 and 20, nearly doubling the 57 overdose deaths last year during the same time frame, according to data provided by the Metro health department. 

In Memphis, 58 people died of suspected drug overdoses from April 7- May 7, the highest county total in one 30-day period since health officials began collecting data. 

“This action was urgently needed to address the overdose deaths we are now experiencing,” said Terri Sabella, CEO of the Tennessee Primary Care Association. 

Sabella said that about six of Tennessee’s 29 federally qualified health care centers, which offer primary care to individuals on a sliding-scale regardless of insurance, have expressed interest in providing MAT, but have not been able to before. Some of the centers are providing MAT already, she said. 

Clinics like those operated by Neighborhood Health, a federally qualified health center, can provide MAT as well as other services based on a more affordable fee scale through nurses and physician assistants who are trained in the medication and supervised by physicians. 

“Community health centers like ours are already part of the solution, and we are getting ready to expand care for even more uninsured and underserved who urgently need MAT,” said Brian Haile, CEO of Neighborhood Health, which has 12 clinics in Nashville and Lebanon. “This bill will save lives.”

The measure was carried by Sen. Steve Dickerson, R-Nashville and a physician, and Rep. Matthew Hill, R-Elizabethtown. 

The governor is expected to sign the measure. If he does, it will go into effect July 1. Nurses and physician assistants would be required to undergo the same level of training as physicians before prescribing.