Question about schedule II prescriptive authority

  1. I have a question for those APNs who have experience with prescribing schedule II drugs...

    I just started working as an NP in a Pain Management clinic here in Ohio. I have my DEA # for schedule II-V drugs.

    I recently found out from reading the CTP section of the Ohio board of nursing that APNs are only limited to prescribe schedule II meds to "terminally ill" patients and that the Rx written should not exceed a 24 hour use.

    Now, I see patients with chronic pain who need prescription renewals of their schedule II meds. We usually renew their scripts for a month at a time.

    Is there an exception to this rule of limited schedule II prescribing by APNs? I also found a form within the Ohio board of nursing for a "Formulary Revision/Request". I wonder if this form can be used to request writing of schedule II meds for patients with chronic pain?

    Are there other NPs in other states with the same limitation on prescribing schedule II drugs? I don't recall having had this problem when I was in California.

    Thanks.
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  2. 4 Comments

  3. by   sirI
    Quote from vinnysca
    I have a question for those APNs who have experience with prescribing schedule II drugs...

    I just started working as an NP in a Pain Management clinic here in Ohio. I have my DEA # for schedule II-V drugs.

    I recently found out from reading the CTP section of the Ohio board of nursing that APNs are only limited to prescribe schedule II meds to "terminally ill" patients and that the Rx written should not exceed a 24 hour use.

    Now, I see patients with chronic pain who need prescription renewals of their schedule II meds. We usually renew their scripts for a month at a time.

    Is there an exception to this rule of limited schedule II prescribing by APNs? I also found a form within the Ohio board of nursing for a "Formulary Revision/Request". I wonder if this form can be used to request writing of schedule II meds for patients with chronic pain?

    Are there other NPs in other states with the same limitation on prescribing schedule II drugs? I don't recall having had this problem when I was in California.

    Thanks.
    Hello, vinnysca,

    The way I interpret your state's APN prescribing law is that APNs have "very narrow parameters in the law for prescribing Schedule II drugs":

    http://www.nursing.ohio.gov/PDFS/For...authINSERT.pdf

    I seriously doubt the Forumulary change to which your refer makes any difference in this law.
  4. by   cgfnp
    I'm afraid I agree with Siri... only 24 hr unless the doc writes it there. That is rediculous, but not as rediculous as in my home state (Missouri), where NO controlled substances are allowed. (one of only two states left). It's truly baffling. I've never heard one good reason for this. The docs in Missouri want to retain the power, I guess. Here's food for thought: I've seen a doctor inappropriately prescribe and manage Coumadin, which Missouri NPs can prescribe, but I've never heard of or seen a NP inappropriately prescribe a controlled substance. Chew on that one, Missouri docs. If you're worried about "danger" then take away the Theophylline, Coumadin, Neurontin, Tegretol, Dilantin, and Digoxin too (and all the chronic multi-problem-one-hour-per-patient-visit patients that come with it).
    Last edit by cgfnp on Oct 29, '06
  5. by   MaleAPRN
    I know that each state sets their own laws as far as NP prescriptive authority, and that it is clearly influenced by the medical association lobbies. It is unfortunate that by lobbying to limit our abilities to write for certain scheduled drugs, that they are truly doing themselves a disservice.

    I was talking to my three anesthesiologists who I work with in the pain department. They are all willing to even sign a petition to help change some restrictions for NPs such as myself to be able to write schedule II drugs in the pain management arena. I know that it would be close to getting an act of Congress to propose such a measure. But, I'm completely unaware on where to even start such a feat!

    I guess I have to start by contacting my NP state representative and ask what steps I may take to even get my proposal in the agenda for the state.

    Any ideas guys?

    Thanks.

    Vince.
    NP/CRNA
  6. by   cgfnp
    Quote from vinnysca
    I know that each state sets their own laws as far as NP prescriptive authority, and that it is clearly influenced by the medical association lobbies. It is unfortunate that by lobbying to limit our abilities to write for certain scheduled drugs, that they are truly doing themselves a disservice.

    I was talking to my three anesthesiologists who I work with in the pain department. They are all willing to even sign a petition to help change some restrictions for NPs such as myself to be able to write schedule II drugs in the pain management arena. I know that it would be close to getting an act of Congress to propose such a measure. But, I'm completely unaware on where to even start such a feat!

    I guess I have to start by contacting my NP state representative and ask what steps I may take to even get my proposal in the agenda for the state.

    Any ideas guys?

    Thanks.

    Vince.
    NP/CRNA
    I guess that's where to go. I tried emailing my state association and didn't even get a reply. What a well-managed organization. So needless to say I'm not putting much stock into them helping. Get a lot of providers to write/call/email your reps so they get the message to actually do something.

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