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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.
| State | Practice Authority (AANP) | Prescriptive Authority (DEA) |
|---|---|---|
| Alabama | NPs have reduced practice authority. | NPs may prescribe and administer medications. They need a special permit for Schedule II and IIN substances. |
| Alaska | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Arizona | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Arkansas | NPs have reduced practice authority. | NPs may order, administer, and prescribe scheduled substances III–V. They can prescribe Schedule II hydrocodone products only if they have collaborative practice agreements. Authority can extend to CII and CIIN substances if in accordance with Arkansas Act 593. |
| California | NPs have restricted practice authority. | NPs may prescribe, dispense, and administer scheduled substances II–V. There are additional state requirements for Schedule II substances. |
| Colorado | NPs have full practice authority. | NPs may prescribe scheduled substances II–V and may dispense and administer samples. |
| Connecticut | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Delaware | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| District of Columbia | NPs have full practice authority. | NPs may prescribe scheduled substances II–V. |
| Florida | NPs have restricted practice authority. | NPs may prescribe, dispense, and administer scheduled substances II–V only in accordance with state law. |
| Georgia | NPs have restricted practice authority. | NPs may prescribe, administer, and dispense scheduled substances III–V. |
| Guam | NPs have full practice authority. | NPs may prescribe scheduled substances II–V. |
| Hawaii | NPs have full practice authority. | NPs may administer and prescribe scheduled substances II–V. |
| Idaho | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Illinois | NPs have reduced practice authority. | NPs may prescribe, dispense, and administer scheduled substances II–V. They have a 30-day supply limit for prescriptions of Schedule II substances. |
| Indiana | NPs have reduced practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Iowa | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Kansas | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V in accordance with collaborative agreements. |
| Kentucky | NPs have reduced practice authority. | NPs may prescribe scheduled substances II–V. |
| Louisiana | NPs have reduced practice authority. | NPs may prescribe and dispense scheduled substances II–V only for attention deficit disorder. |
| Maine | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Maryland | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Massachusetts | NPs have full practice authority. | NPs may prescribe, administer, and procure scheduled substances II–V. |
| Michigan | NPs have restricted practice authority. | NPs may prescribe scheduled substances II–V. Prescriptions for Schedule II substances require a physician’s letter. |
| Minnesota | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Mississippi | NPs have reduced practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Missouri | NPs have restricted practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances III–V and Schedule II hydrocodone products with collaborative practice agreements. Scheduled substances II–III have a supply limit of five days. Additional state requirements for prescriptive authority include a controlled substances registration from the Missouri Bureau of Narcotics and Dangerous Drugs (BNDD). |
| Montana | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Nebraska | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Nevada | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| New Hampshire | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V, per formulary. |
| State | Practice Authority (AANP) | Prescriptive Authority (DEA) |
|---|---|---|
| New Jersey | NPs have reduced practice authority. | NPs may prescribe scheduled substances II–V. |
| New Mexico | NPs have full practice authority. | NPs may prescribe, procure, and dispense scheduled substances II–V. |
| New York | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| North Carolina | NPs have restricted practice authority. | NPs may prescribe, dispense, and procure scheduled substances II–V. Schedule II–III substances have a supply limit of 30 days. |
| North Dakota | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Northern Mariana Islands | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Ohio | NPs have reduced practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Oklahoma | NPs have restricted practice authority. | NPs may prescribe scheduled substances III–V. |
| Oregon | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Pennsylvania | NPs have reduced practice authority. | NPs may prescribe scheduled substances II–V. Schedule II substances have a supply limit of 30 days, and Schedules III, IIIN, IV, and V have a 90-day supply limit. |
| Puerto Rico | NPs have reduced practice authority. | NPs do not have prescriptive authority. |
| Rhode Island | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| South Carolina | NPs have restricted practice authority. | NPs may prescribe scheduled substances II–V. Schedule II substances have a five-day supply limit, and schedule IIN substances have a 30-day supply limit. |
| South Dakota | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Tennessee | NPs have restricted practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Texas | NPs have restricted practice authority. | NPs may prescribe and administer scheduled substances III–V. Schedule II and IIN substances may be prescribed/ordered in hospital and hospice settings only. |
| Utah | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V, per formulary. |
| Vermont | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Virgin Islands | NPs have reduced practice authority. | NPs may prescribe and dispense scheduled substances IV–V. |
| Virginia | NPs have restricted practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Washington | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| West Virginia | NPs have reduced practice authority. | NPs may prescribe, administer, and dispense scheduled substances III–V. They may only prescribe II and IIN substances. |
| Wisconsin | NPs have reduced practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
| Wyoming | NPs have full practice authority. | NPs may prescribe, dispense, administer, and procure scheduled substances II–V. |
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
