[hen-ui-text variant=”b4″]Nurse practitioner (NP) prescriptive authority varies according to state laws. [hen-ui-link href=”/nurse-practitioner/can-nurse-practitioners-prescribe-medication/”]Many states allow NPs[/hen-ui-link] to administer, dispense, prescribe, and procure medications. However, some jurisdictions require a collaborative practice agreement between an NP and a physician. Other states limit the duration of the prescription (e.g., five-day or 30-day supplies only) or the types and purposes of the drugs prescribed.[/hen-ui-text][hen-ui-text variant=”b4″]Find out more about which states nurse practitioners can prescribe medication in this guide.[/hen-ui-text][hen-ui-heading variant=”h2″]What is Nurse Practitioner Prescriptive Authority?[/hen-ui-heading][hen-ui-text variant=”b4″][hen-ui-link href=”/nurse-practitioner/can-nurse-practitioners-prescribe-medication/#full-practice-states”]Nurse practitioner prescriptive authority[/hen-ui-link] allows NPs to prescribe medications. The American Association of Nurse Practitioners divides prescriptive authority into three categories:[/hen-ui-text][hen-ui-text variant=”b4″]Source: [hen-ui-link href=”https://www.deadiversion.usdoj.gov/” target=”_blank”]U.S. DOJ and DEA Diverson Control Division[/hen-ui-link], December 2, 2022[/hen-ui-text] [/hen-ui-text-stack] [/hen-ui-accordion-item][/hen-ui-accordion][hen-ui-text variant=”b4″ class=”mt-6″]As of December 2, 2022, NPs who meet state-specific requirements and limitations can prescribe schedule II-V drugs in all states except Georgia and Oklahoma, where NPs can only prescribe schedule III-V controlled substances.[/hen-ui-text][hen-ui-heading variant=”h2″]Obtaining Prescriptive Authority as a Nurse Practitioner[/hen-ui-heading][hen-ui-text variant=”b4″]Requirements for obtaining nurse practitioner prescriptive authority vary by jurisdiction, with some states granting prescriptive authority as part of the licensing process and others imposing additional requirements. The procedural differences can depend on whether the state allows NPs full practice, reduced, or restricted practice authority.[/hen-ui-text][hen-ui-text variant=”b4″]Generally, prescriptive authority requires an application to the federal [hen-ui-link href=”https://apps.deadiversion.usdoj.gov/webforms2/spring/main?execution=e1s1″ target=”_blank”]Drug Enforcement Agency[/hen-ui-link] (DEA) and adherence to all state requirements, including current and active licensing, potential supervisory or collaborative practice agreements, and any applicable continuing education and training. NPs use Form 224 specific to mid-level practitioners.[/hen-ui-text][hen-ui-text variant=”b4″]When nurse practitioners apply to register with the DEA, it is crucial to carefully consider the address they provide on their application. NPs working in restricted practice states must use their practice address as the designated address for both the DEA application and license.[/hen-ui-text][hen-ui-text variant=”b4″]If an NP changes employer or takes a leave of absence, they will not be granted a DEA renewal unless they can provide evidence of a new position and a supervising agreement.[/hen-ui-text][hen-ui-heading variant=”h3″]Physician Involvement and Collaborative Practice Agreements[/hen-ui-heading][hen-ui-text variant=”b4″]Some reduced practice states require collaborative practice agreements that detail the working relationship between physicians and [hen-ui-link href=”/nurse-practitioner/”]nurse practitioners[/hen-ui-link]. These agreements include the terms of NPs’ prescriptive authority. States in which NP practice is more restrictive may require physician supervision for practice and prescribing medications.[/hen-ui-text][hen-ui-text variant=”b4″]Collaborative relationships between NPs and physicians can foster better communication and positive outcomes. As NPs become more specialized and independent, many states have allowed them to practice and prescribe more autonomously.[/hen-ui-text][hen-ui-text variant=”b4″]Today, NPs have full practice authority in 28 states and Washington D.C. The remaining states are split between reduced and restricted practice/prescribing authority, requiring collaborative practice agreements, physician oversight, or other restrictions.[/hen-ui-text][hen-ui-separator /][hen-ui-text variant=”b4″]Information on prescriptive authority was retrieved on August 10, 2023. Check with your state board of nursing for the most current information regarding prescriptive authority.[/hen-ui-text][hen-ui-text variant=”b4″]Page last reviewed August 16, 2023[/hen-ui-text]
- Full practice permits NPs to prescribe independently.
- Reduced practice may require a collaborative practice agreement with a physician or limits on the prescribed medications.
- Restricted practice requires physician supervision or delegation when prescribing controlled substances.
- Schedule II includes substances with high abuse potential, such as amphetamine, codeine, and hydrocodone.
- Schedule III substances have less abuse potential and include compounds that contain limited Schedule II drugs, such as Tylenol with codeine.
- Schedule IV, with lower abuse potential than Schedule III drugs, includes barbital and Xanax.
- Schedule V, with the lowest abuse potential, consists of preparations with limited quantities of narcotics and stimulants, such as analgesics.