CRNAs and Medication-Assisted Treatment (MAT)

AANA Position Statement and Considerations

The AANA supports increased patient access to safe, responsible use of MAT for the comprehensive treatment of substance and opioid use disorder. Please review the position statement and considerations document Certified Registered Nurse Anesthetists Medication-Assisted Treatment for more information on MAT, a CRNA's ethical obligation and  professional responsibility, prescriptive authority limitation, and steps for obtaining the MAT waiver.  

Anesthesia Considerations for Patients on MAT, in Active State of Opioid Use Disorder, or Opioid Therapy

• AANA Practice Considerations: Analgesia and Anesthesia for the Substance Use Disorder Patient (2019)
• AANA Journal article: The Opioid Crisis and the Certified Registered Nurse Anesthetists: Caring for Patients receiving Medication-Assisted Treatment June 2019 Guest Editorial
• American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Management of Patients on Preoperative Opioid Therapy, Anesthesia Analgesia

MAT Waiver Application and Related Info

The waiver application for CRNAs to prescribe buprenorphine as medication-assisted therapy is not available yet on the SAMHSA website. Please email practice@aana.com with subject “MAT” if you’d like email notice when the waiver is accessible. Here is some background and related resources on the topic.  

Substance Abuse and Mental Health Administration (SAMHSA)

• All About Medication-Assisted Treatment (MAT)
• Current related Legislation, Regulations, and Guidelines
• Buprenorphine Treatment Practitioner Locator
• Buprenorphine info center 866-287-2728

U.S. Food & Drug Administration (FDA) 

• FDA announces public health emergency prioritization of ANDAs for drug products for the emergency treatment of opioid overdose 
• Statement from Commissioner Scott Gottlieb, M.D., on 2019 policy and regulatory agenda for continued action to forcefully address the tragic epidemic of opioid abuse, February 26, 2019
• Statement from Commissioner Scott Gottlieb, M.D., on new regulatory authorities as part of the newly enacted SUPPORT for Patients and Communities Act, October 24, 2018  

U.S. Department of Health & Human Services (HHS) Office of the Surgeon General

• Facing Addiction in America, The Surgeon General's Spotlight on Opioids, September 2018

National Academies of Sciences, Engineering and Medicine

• Committee On Medication-Assisted Treatment for Opioid Use Disorder 

National Conference of State Legislatures (NCSL)

• NCSL Scope of Practice Policy map indicating the number of nurse practitioners (NPs) and physician assistants (PAs) prescribing buprenorphine by state, based on SAMSHA waivers issued: Behavioral Health Providers Overview

National Institutes of Health (NIH)

• Monthly buprenorphine injections effective for opioid use disorders

International Nurses Society on Addiction (IntNSA) 

• Mission: To advance excellence in nursing care for the prevention and treatment of addictions for diverse populations across all practice setting through advocacy, collaboration, education, research and policy development.
• Addiction Nurses Save Lives