By: Jacqueline Bain
For many years, medical providers and regulators have wrestled with whether Advance Registered Nurse Practitioners (“ARNPs”) and Physician Assistants (“PAs”) should be able to prescribe controlled substances. This past legislative session, several bills were signed into law allowing ARNPs and PAs to prescribe controlled substances subject to several limitations and restrictions. This article will set forth a broad overview of the bills. However, if your practice intends to use ARNPs or PAs to prescribe controlled substances, we strongly recommend that each practitioner is educated about the boundaries set forth in the new law. For instance, there are restrictions on prescribing certain controlled substances in certain circumstances, prescribing controlled substances within a pain management clinic, and prescribing controlled substances for persons under age 18. It is important that all practitioners are properly educated prior to engaging in prescribing or dispensing any controlled substances.
Advance Registered Nurse Practitioners
ARNPs may prescribe or dispense Schedule II, III or IV controlled substances if they have graduated from a program leading to a master’s or doctoral degree in a clinical nursing specialty area with training in specialized skills and have completed 3 hours of continuing education on the safe and effective prescription of controlled substances. ARNPs must limit their prescriptions of Schedule II controlled substances to a 7-day supply. However, this restriction does not apply to psychiatric ARNPs who are prescribing psychiatric medications.
The prescribing or dispensing ARNP must adhere to the same standards of practice as a physician who would prescribe or dispense a controlled substance under Florida Statutes Section 456.44.
Moreover, an ARNP may be disciplined if s/he prescribes or dispenses a controlled substance that violates the standard of acceptable and prevailing nursing practice, including engaging in acts for which the ARNP is not qualified by training or experience. S/he may also be disciplined for signing blank prescription forms or prescribing certain controlled substances beyond for the treatment of certain ailments, promoting certain pharmacies to fill these prescriptions. Moreover, ARNPs may be disciplined for prescribing HCG or other hormones for the purposes of muscle building or to enhance athletic performance.
The Board of Nursing is in the process of establishing a committee to recommend a formulary of controlled substances that an ARNP may not prescribe or may only prescribe for specific uses or in specific quantities.
Physician Assistants
PAs may prescribe Schedule II, III or IV controlled substances if a supervisory physician has delegated to that PA the authority to prescribe or dispense any such medication and the medication is used in the supervisory physician’s practice. PAs must limit their prescriptions of Schedule II controlled substances to a 7-day supply. PAs must complete three (3) continuing education hours on the safe and effective prescribing of controlled substances.
The prescribing or dispensing PA must adhere to the same standards of practice as a physician who would prescribe or dispense a controlled substance under Florida Statutes Section 456.44.
ARNPs and PAs may not begin prescribing controlled substances until January 1, 2017.