Nurse Practitioner Prescriptive Authority

Nurse practitioners, being highly educated and experienced in the field of nursing, are given prescriptive authority to varying degrees across the United States. The extent of a nurse practitioner’s prescriptive authority largely varies by the schedule of the drug in question, with some states allowing a larger degree of prescriptive authority to nurse practitioners and some regulating this prescriptive authority more closely.

The following is a state-by-state breakdown of nurse practitioner prescriptive authority, according to the American Medical Association (AMA)’s Nurse practitioner prescriptive authority - State law chart as of 2017. Check with your state’s board of nursing for more up-to-date information.

Schedule II, III, IV, and V drugs can be found described by the Drug Enforcement Administration (DEA) - Diversion Control Division Controlled Substances Schedules.

Schedule II Controlled Substances Prescriptive Authority

Schedule II substances have a high potential for abuse which could leave to either severe psychological or physical dependence. These substances include hydromorphone, methadone, oxycodone, and fentanyl.

As of 2017, according to the AMA’s nurse practitioner prescriptive authority, states that allow nurse practitioner’s prescriptive authority for drugs falling into schedule II:

  • Alabama - *With a special permit approved by the Alabama Board of Medical Examiners (ALBME)
  • Alaska
  • Arizona
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia (D.C.)
  • Florida - * 7-day limit except for psychiatric controlled substances, for which there is no limit. Only psychiatric nurse practitioners are allowed to prescribe psychiatric medication to children under 18.
  • Hawaii
  • Illinois - *30-day supply
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana - *Nurse practitioners may only prescribe with authority granted by the Board of Nursing.
  • Maine
  • Maryland
  • Massachusetts
  • Michigan - *7-day supply only upon release of patient.
  • Minnesota
  • Mississippi
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina - * 30-day supply
  • North Dakota
  • Ohio
  • Oregon
  • Pennsylvania - *30-day supply
  • Rhode Island - *Nurse practitioners with a population focus in psychiatric/mental health may prescribe schedule II substance classified as stimulants.
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • Wisconsin - *Only in very limited circumstances.
  • Wyoming

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Schedule III-V Controlled Substances Prescriptive Authority

Schedule III substances are described as having a potential for abuse less than schedule I or II and such abuse could lead to a level of moderate to low physical dependence or a high psychological dependence. These include substances with less than 90mg of codeine per dosage, for example.

Schedule IV substances have a low potential for abuse when compared to substances in schedule II. These may include Xanax, Klonopin, and Valium.

Schedule V substances have a low potential for abuse when compared to schedule IV substances and consist mostly of limited quantities of certain narcotics, such as cough medicines with no more than 200mg of codeine per 100ml.

Generally speaking, the lower the schedule number, the more potential a drug has to be dangerous or misused and therefore requires a higher level of regulation.

As of 2017, according to the AMA’s nurse practitioner prescriptive authority, states that allow nurse practitioner’s prescriptive authority for drugs falling into schedule  III, IV or V:

  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia (D.C.)
  • Florida - *Only psychiatric nurse practitioners are allowed to prescribe psychiatric medications to children under 18.
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina - *Limited to 30-day supply
  • North Dakota
  • Ohio
  • Oklahoma - *Limited to 30-day supply
  • Oregon
  • Pennsylvania - *Limited to 90-day supply
  • Rhode Island - *Nurse practitioners may prescribe schedule III and IV controlled substances within regulations.
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia - *Schedule III controlled substance prescription is limited to 30-day supply with no refill.
  • Wisconsin
  • Wyoming

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Information on prescriptive authority was last retrieved on February 11, 2020. For the most up-to-date information, check with your state board of nursing.