Can Nurse Practitioners Prescribe Medication?

Prescriptive authority for nurse practitioners (NPs) will vary widely by state. NPs are advanced practice registered nurses (APRNs). After completing their master of science in nursing (MSN) degree, an NP’s advanced training allows them prescription privileges. When warranted, NPs can prescribe medication, like antibiotics or controlled substances, that patients cannot purchase over the counter.

However, NPs’ prescriptive authority may be restricted depending on the specific rules in their state. What medications NPs cannot prescribe depends on which state they are licensed in. For example, in some states, NPs cannot prescribe certain controlled substances that doctors are allowed to prescribe.

Learn more about NP prescription privileges and prescribing authority by state and how the prescribing roles of NPs differ from those of doctors.

Many states grant full practice authority to NPs, allowing them to practice at the top of their training without the supervision of a physician. Since NPs often work independently of doctors, they have more autonomy to manage medications than a registered nurse (RN).

NPs and doctors prescribe drugs based partly on this “Schedule” classification system. The scheduled classification system identifies medications that have the potential to be abused or cause dependency in individuals. These medications are also referred to as controlled substances.

The scheduled drugs below are regulated by the Drug Enforcement Administration (DEA), the state an NP practices in, and if they have a collaborative agreement with a doctor.

Medical providers with prescriptive authority do not prescribe Schedule I drugs. The federal government ruled Schedule I drugs have no accepted medical use in the U.S. However, in some states like New York, NPs can prescribe medical marijuana, which is classified as a Schedule I drug.

Antibiotics, antidepressants, blood pressure and diabetic medications fall outside of these categories. They are considered non-controlled substances. NPs can prescribe these medications.

NP prescribing authority varies by state. The American Association of Nurse Practitioners (AANP) divides how NPs can prescribe into three categories:

For example, NPs licensed in Georgia can only administer, dispense, and prescribe scheduled drugs III-V. However, in Washington, NPs can administer, dispense, prescribe, and acquire scheduled drugs II-V.

NPs licensed in Georgia must also complete 15 hours of continued education in pharmacology every time they renew their license.

NPs in states that allow prescriptions of scheduled drugs II-V can prescribe psychiatric medications like Adderall, which is classified as a Schedule II drug.

Depending on the classification of drugs, state regulations, and if NPs have full practice authority, there are medications NPs cannot prescribe.

In all states except Georgia, Oklahoma, South Carolina, and West Virginia, NPs can prescribe medications like physicians. NPs in these three states may need physician approval for certain prescriptions. Some NPs are also prohibited from prescribing Schedule II drugs like Adderall, methadone, or fentanyl.

However, in many states, NPs can prescribe several common medications that doctors also prescribe, such as antibiotics, antifungals, hypertensive medications, and diabetic medications. Make sure to check what is allowed in your state.

NPs and doctors have similar roles, but differences do exist.

The primary difference between these two roles involves the educational pathways and training required. Doctors must complete a bachelor’s degree and a doctor of medicine degree. NPs also graduate with bachelor’s degrees, but instead, they earn a master of science in nursing (MSN) or a doctor of nursing practice (DNP).

In addition, doctors participate in a residency while NPs complete a practicum. Residency is longer than NP practicums — several years for doctors compared to 1-2 years for NPs.

Overall, it takes about 10 years to become a fully practicing and licensed doctor. Nurse practitioners can earn their licensure after about six years, although many take longer by gaining experience in their registered nurse career before applying to DNP or MSN programs.

Once they begin carrying out their professional duties, doctors also have more autonomy than NPs. For example, they do not need to enter into collaborative or supervisory agreements with other healthcare professionals to prescribe medication. In some states, NPs have full practice autonomy, but several states restrict nurse practitioners.