Nursing the Opioid Crisis

Access to healthcare providers remains a salient problem in the United States. One important policy solution would be to relax state scope-of-practice (SOP) laws that inhibit the ability of many healthcare providers, such as nurse practitioners, to deliver care. Some states have changed their SOP laws to allow nurse practitioners to practice independently; many other states have refused to do so, citing patient safety concerns. This paper examines the impact of relaxing such laws in the context of another public health crisis—the opioid epidemic. The epidemic arose within the healthcare system and is intimately connected with patient safety, thus it is an ideal setting in which to evaluate patient safety concerns. Analyzing a comprehensive dataset of opioid-related deaths between 2005 and 2017, I find no empirical evidence to support the contention that relaxing SOP laws endangers patient safety. Instead, I find consistent and statistically significant evidence that eliminating SOP restrictions reduces opioid-related deaths by 5 to 11 percent. This evidence supports making relaxations of SOP laws permanent and more widespread. This paper offers several state and federal policy options to relax SOP laws and meaningfully improve access to care permanently