Nurse practitioners (NPs) nationwide are stepping up in light of a physician shortage and are providing accessible healthcare to more Americans. NPs are highly educated and trained healthcare providers, yet unlike physicians, their practice authority is not uniform across the country but varies from state to state. Their level of practice authority directly intersects with whether NPs can prescribe medications or not, which is referred to as prescriptive authority. In this article, we’ll review what determines if an NP can prescribe medications (or not), what prescriptive authority is in each state, and answer some common questions you may have.
Information for this guide was sourced in December 2023 primarily from the American Nurses Association (ANA), the American Association of Nurse Practitioners (AANP), and the Drug Enforcement Agency (DEA) and is subject to change with state legislation. For the most current information, contact the board of nursing for your state.
Nurse Practitioner Practice and Prescriptive Authority
Let’s get straight to your question: Can nurse practitioners write prescriptions? The answer depends on the state and the type of medication in question. Nurse practice authority and prescriptive authority intersect and may correlate, but they do not automatically inform each other.
Practice authority falls into three categories: full, reduced, and restricted. These categories indicate an NP’s level of independence from supervision or collaboration with physicians as follows:
- Full: NPs can practice independently to the full scope of their licensure, which includes prescriptive authority. Some states with full practice authority only allow full practice authority following a set amount of time or experience under physician collaboration or oversight.
- Reduced: NPs must have regulated collaborative agreements with other healthcare providers (typically physicians). Therefore, their authority and possible work settings are limited to some degree.
- Restricted: NPs’ scope of practice is limited; they cannot work independently. They are required to have physician supervision.
Prescriptive authority laws in certain states—even states with full practice authority for NPs—may levy additional requirements, including the following:
- A state agency controlled substances certification/registration/license
- Continuing education hours specific to pharmacology and controlled substances
- Collaborative practice agreements
- Letters of physicians
- An established period with physician oversight or supervision
- Tracking and inquiry
Practice Authority and Prescriptive Authority of NPs by State
The following table identifies the practice and prescriptive authority in each state for your reference.
Frequently Asked Questions
What Can a Nurse Practitioner Do?
According to the AANP, “NPs assess patients, order and interpret diagnostic tests, make diagnoses and initiate and manage treatment plans — including prescribing medications.” Read our in-depth resource guide to learn more about what a nurse practitioner is.
What Can a PA Do That an NP Cannot?
A physician’s assistant (PA) is a different healthcare career than an NP, with similarities and differences. Both are considered mid-level healthcare practitioners, and their salaries are often comparable. PAs have a medical perspective and training background aimed at treating diseases, whereas NPs have a nursing perspective of healing and wellness. Almost 25 percent of physician assistants have surgery subspecialties, whereas 88 percent of NPs are certified in a primary care specialty.
Who Can Prescribe Antidepressants?
Antidepressants are prescription medications; therefore, only a healthcare provider with appropriate prescriptive authority may prescribe them.
Can Nurse Practitioners Prescribe Adderall?
Adderall is a Schedule II controlled substance. Depending on an NP’s prescriptive authority, they may be able to prescribe it.
Can Registered Nurses Prescribe Medications?
No. Medication administration may be part of a registered nurse’s (RN’s) job responsibilities, but they are not allowed prescription authority in any state.
What Medications Can Nurse Practitioners Not Prescribe?
It depends on their prescriptive authority, which depends on the laws and regulations of the state where the NP practices. In the table above, you can see that several states place additional restrictions or regulations on Schedule II substances.
What Is the Meaning of APRN?
APRN is an acronym that stands for advanced practice registered nurse.
Are You Interested in a Nurse Practitioner Career Path?
Are you an RN considering a career as an NP? Picking up per diem shifts in hospitals with Nursa may have you collaborating often with NPs. Learn more about the differences between RNs and NPs, and continue exploring the idea of becoming a nurse practitioner.
Additional Sources:
- Guttmacher Institute: “Nurses’ Authority to Prescribe or Dispense”
- Hawai’i Pacific University: Can Nurse Practitioners Prescribe? 5 Scope of Practice Answers
- NCCPA: Statistical Profile of Certified PAs by Specialty
- AANP: NP Fact Sheet
- Missouri Department of Health and Senior Services: Bureau of Narcotic and Dangerous Drugs
