Controlled substances have a substantial effect on people’s health, and their misuse is dangerous and should be prevented. For this reason, the Drug Enforcement Administration (DEA) has installed a licensing procedure for all medical professionals, including Nurse Practitioners (NPS). However, the laws differ by state; in New Jersey, for example, NPs do not have full authority over their activities. The first case study will be examined to show that an NP can benefit from obtaining a DEA number in a rural setting.
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In the discussed case, Lori has a Bachelor’s degree as an FNP. She is a recently certified nurse who has accepted a position at a Primary Care Clinic in a small town. Here, it is vital to note that primary care providers deal with a wide variety of problems on a daily basis. Thus, some patients may have a small complaint, while others can require assistance in managing a chronic condition. The fact that Lori will practice in a small town implies a close-knit community and a strong nurse-patient relationship.
Appropriate Prescriptive Authority and the DEA Registration Process
An NP’s authority to prescribe controlled substances depends on their state of practice. In some areas, NPs can act without physicians’ guidance, while others require collaboration and additional education. In NJ, NPs have to collaborate with a physician, and they have the right only to prescribe controlled substances of schedules II-V (Drug Enforcement Administration, 2019). Furthermore, NPs have to complete a course for safe prescribing and controlled substances prior to gaining access to this ability (Scope of Practice Policy, 2019). Therefore, in Lori’s situation, she will have to consult her physician in a real-life conversation or by telephone before prescribing a controlled substance.
Moreover, Lori has to obtain the DEA number, which is required for medical workers in all states to work with controlled substances. While it is not necessary if Lori does not prescribe such medications, it could help her provide better care to her patients. To receive the DEA number, Lori has to complete a course in pharmacology, as requested by state laws, and apply to the DEA for number registration (Buppert, 2018).
The fee for her level of working with substances (prescribing) is $731, and the license will be active for three years (Buppert, 2018, p. 204). Lori has to fill the application and confirm her education, experience, and knowledge of the subject.
Safe Prescribing Practices
While Lori will work in a setting where pain medication may not be the main subject of all patient visits, she will need to stay attentive to her patients’ requests. It is essential to exhaust other options when considering controlled substances. These drugs have a strong effect on one’s health and cause addiction – other drugs or non-pharmacological treatments have to be proven ineffective first (Buppert, 2018).
Next, Lori has to review the patient’s history of drug or substance abuse before deciding to prescribe a controlled substance – some individuals may not seek pain relief but continue their abusive practices (MidLevelU, 2017). Finally, Lori should remember to document every aspect of such prescriptions, including patient history, reasons for prescribing, alternative solutions and their ineffectiveness, physician collaboration outcomes, and drug testing results. A pain contract can also be a part of such documentation to clarify the patient’s rights and responsibilities.
Although Lori’s working environment does not imply her interacting with controlled substances every day, she has to be prepared to deal with all risks that are connected to this practice. A DEA number is required to prescribe controlled substances, but Lori also has to educate herself and collaborate with a physician, depending on the state’s scope of practice laws. To prescribe safely, the NP needs to consider patients’ social history, responses to other treatments, and the effectiveness of controlled substances.
Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.
Drug Enforcement Administration. (2019). Mid level practitioners – Controlled substance authority by discipline within state. Web.
MidLevelU. (2017). Medical records: What must be included from a prescribing standpoint? Web.
Scope of Practice Policy. (2019). New Jersey scope of practice policy: State profile. Web.