The United States currently has 17 states including the District of Columbia that have legislation that grants nurse practitioners some form of prescriptive authority for controlled substances without the involvement of the physician (Ambrose & Tarlier, 2013). A controlled substance is a drug or chemical whose use is under the control of the government, including the manufacture and possession. The nurses with prescriptive authority must have a license that requires them to administer the controlled substance to particular patients that need them. However, as witnessed in the case of Heather Alfonso, the prescriptive authority can be prone to misuse hence placing the lives of individuals at risk.
First, the prescriptive authority can be associated with malice and unethical behavior. Nurses with this power can engage in unscrupulous activities that lead to the increased abuse of restricted drugs such as opioids. As such, the prescriptive authority can have a counterproductive effect that in turn, puts the lives of the patients at risk (Martsolf, Arifkhanova, & Auerbach, 2015). Nurses can also engage in the prescription of these drugs to undeserving individuals, including the civilians, thus increasing the problem of drug abuse that the government continues to fight through its War on Drugs program. Also, the prescriptive authority has also brought confusion in the roles between the nurse and the physician. The 17 states and the District of Columbia have allowed the nurse to practice their authority without the intervention of the physician. However, this can lead to serious confusion of roles in a cares setting.
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In a bid to avoid these issues, specific considerations must be taken. Clear laws and policies should be created as to the patients that warrant the controlled substances and the regimen required (Peirce et al., 2012). Secondly, stringent licensing measures should be put in place to ensure that only qualified, and ethical practitioners are accorded this power.
References
Ambrose, M. A., & Tarlier, D. S. (2013). Nurse practitioners and controlled substances prescriptive authority: Improving access to care. Nursing leadership (Toronto, Ont.), 26(1), 58-69.
Martsolf, G., Arifkhanova, A., & Auerbach, D. I. (2015). The impact of full practice authority for nurse practitioners and other advanced practice registered nurses in Ohio. Santa Monica, CA: Rand Corporation.
Peirce, G. L., Smith, M. J., Abate, M. A., & Halverson, J. (2012). Doctor and pharmacy shopping for controlled substances. Medical care, 494-500.
