Prescribing Authority and Restrictions: A State-by-State Overview

By: John Cole

Reading Time: 2 minutes

shutterstock_505244407-1To address our nation's opioid epidemic, states are increasingly taking action at the prescription level. This includes enacting mandates on prescribers and their controlled substance prescriptions. Legislators have focused on opioid prescriptions in order to prevent overprescribing, and the resulting regulations primarily fall into four categories:

  1. Restrictions on who can prescribe
  2. Prescription limits
  3. Data requirements
  4. Mandatory Prescription Drug Monitoring Program (PDMP) use


Our team has touched on prescription limits, additional data requirements, and PDMP mandated usage in previous the previous posts:


We have yet to dig into the issue of who can prescribe opioids in each state. States have placed various limits on who can prescribe opioids and Schedule II narcotics. Specifically, these limits focus on mid-level (Physician Assistants and Advanced Practice Registered Nurses) prescribing authorities. When it comes to these restrictions, there is quite a bit of ambiguity and variation from state to state. Additionally, there is little evidence on the "why" behind the variation and the jury is still out on which restrictions are having a statistical impact on over prescribing.

The most up-to-date list of prescribing authority by state can be found in the link below from the DEA:


We will continue to track the legislation and regulations that impact clinicians at the prescribing level on our blog. For updates on this topic, among others, feel free to subscribe below:




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