Empowering Primary Care Nurse Practitioners: A Multilevel Approach to Combating the Opioid Crisis

Abstract

Aims: We offer a literature-driven, empirically informed, and highly warranted recommendation for a multilevel approach tailored to nurse practitioners. This approach aimed to drive change at the individual level (nurse practitioner), dyadic level (nurse-patient therapeutic relationship), and systems level (organisational culture, education, and policy) to strengthen nurse practitioners' capacity to deliver optimal opioid use disorder care.

Background: The opioid overdose epidemic is a global public health crisis, with the United States facing the most severe impact. Access to evidence-based treatment for opioid use disorder remains a significant barrier. Primary care nurse practitioners can play a crucial role in expanding access and bridging the treatment gap. Addressing factors influencing access to, quality of, and effectiveness of treatment requires urgent and careful consideration.

Design: This position paper highlights the multilevel barriers that inhibit nurse practitioners in managing opioid use disorder, negatively impacting treatment access and opioid use disorder-related outcomes.

Method: The Advanced Practice Provider conceptual model was adapted to guide this paper. This adapted model illustrates the interconnected layers among nurse practitioners, clinical care, education, professional development, and organisational culture and policy in caring for patients with opioid use disorder.

Conclusions: Equipping primary care nurse practitioners with the necessary tools to both understand opioid addiction and empower patients experiencing it can have a profound impact. This impact benefits the provider and patient and extends to addressing the opioid crisis at multiple levels. Future research should explore nurse practitioners' experiences when working with individuals with opioid use disorder, identify barriers that hinder positive interactions with patients seeking treatment, and pragmatically test and implement multilevel interventions designed to holistically benefit providers and patient outcomes.

Impact to nursing: This American-based reflection offers valuable insights to nurse practitioners worldwide as they consider effective strategies for addressing opioid use disorder in primary care settings.

Keywords: advanced practice registered nurses; barriers; facilitators; interventions; multilevel nursing approach; nurse practitioners; nursing; opioid use disorder; primary care providers.

FIGURE 1

Advanced Practice Provider conceptual model for NPs treating OUD. (Adapted from Moore (2023)).