Behavioral health providers and peer support specialists serve people who seek help for a variety of mental health and substance use needs, in settings from prevention programs to community-based and inpatient treatment programs. Many types of behavioral health providers and peer support specialists exist to serve a variety of patients.
The links to the right lead to maps showing a comparison of all states and territories for the following five policy areas:
1) addiction counselor credentialing
2) licensed professional counselors’ ability to diagnose
3) authority for nurse practitioners to prescribe buprenorphine-containing products after receiving a waiver from the federal Controlled Substance Act’s special registration requirements
4) authority for physician assistants to prescribe buprenorphine-containing products after receiving a waiver from the federal Controlled Substance Act’s special registration requirements
5) peer support specialist certification
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), medication-assisted treatment (MAT), including opioid treatment programs, combines behavioral therapy and medications to treat substance use disorders. MAT is the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Some states are exploring changes to scope of practice policies to enable greater access to MAT, including the use of buprenorphine-containing products.
Buprenorphine is used as part of MAT for opioid addiction and treats opioid dependence and addiction by diminishing withdrawal symptoms and cravings. Federal laws and regulations provide a framework for medication-assisted treatment on which states may build and implement additional laws and regulations. State law related to physician assistants (PAs) practice authority affects the ability of PAs to prescribe buprenorphine-containing products under the federal framework.
Under current federal law, physicians, PAs may receive a waiver from the Controlled Substance Act’s special registration requirement and prescribe and dispense buprenorphine-containing products for treating opioid use disorder (OUD) if the PA is authorized under state law:
- To prescribe Schedule III, IV or V controlled substances.
- Has proper training or experience to treat and manage patients with OUD.
- Unless authorized to practice independently, practices under the supervision of in collaboration with a physician who is certified, trained or permitted to treat and manage patients with OUD.
There may be instances where a PA in a state has received a waiver to prescribe buprenorphine-containing products, yet the PA’s scope of practice may not allow them to prescribe the MAT. For more information on states requiring supervision or collaboration requirements, please see the physician assistant supervision requirements map page.
The map above shows the number of physician assistants who have obtained a waiver from the federal government to prescribe buprenorphine-containing products as of August 2018 and is based on SAMHSA’s Buprenorphine Treatment Practitioner Locator.