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Senate Passes Nurse-Practitioner Prescription Bill

By Susan Britt
Alabama Political Reporter

MONTGOMERY–On Tuesday, the Alabama Senate passed a bill authorizing nurse-practitioners and certified nurse midwives to prescribe Schedule 3, 4 and 5 controlled substances to patients. The bill SB229 was sponsored by Senator Greg Reed (R-Cordova) who took a point of personal privilege to thank the Senators for their support.

Reed said that the bill came as a result of last year’s healthcare streamlining programs in an effort to increase healthcare access to Alabamians.

SB229’s summary reads, “…to allow for the prescribing of certain schedules of controlled substances by certify registered nurse practitioners 9CRNP) and certified nurse midwives (CNM) with collaborative practice agreements; to provide for the establishment of qualifications required for certified registered nurse practitioners an certified nurse midwives to obtain a Qualified Alabama Controlled Substances Registration Certificate (QACSC); t provide for prescriptive, administering, and dispensing authority of CRNPs and CNMs in possession of a QACSC.”

Reed said, “People think about it in rural areas but a lot of times in urban areas that if they can not be seen by nurse-practitioners they have to wait a long time to be seen by a physician. This is just giving them an opportunity where they can write prescriptions in certain areas where they can’t today.”

Reed gave examples of instances where it is within the scope of a nurse-practitioner’s practice to be able to suture a wound but not to prescribe the need pain medication. Another example was a nurse-practitioner has the ability to diagnose an ear infection but not be able to prescribe the needed antibiotic.
“This just gives the nurse-practitioners more of an opportunity to be able to practice medicine in areas where they are covered completely in their scope of their practice,” said Reed.
Reed said that he had a great deal of support from the Business Council of Alabama and big business. He said that many large employers provide healthcare clinics as a benefit for their employees and to have nurse-practitioners with prescribing capabilities would be a much added benefit.

There are a number of nurse-practitioners that work in a home health setting.

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There are a number of federal healthcare clinics that have nurse-practitioners. They are the only folks there.
“Alabama is one of only two states until this is hopefully passed that does not allow this level of scope increase to nurse-practitioners,” said Reed.

All nurse-practitioners are under the supervision of a physician and those qualified will be issued a DEA certificate by the Board of Medical Examiners. Reed said that although he knows that there is a problem with prescription pain medication abuse. “That is a problem and we need to address that but we don’t need to disenfranchise all of the folks out there that are really in need of healthcare just because we have some folks that don’t want to follow the law.”

Schedule 3, 4 and 5 drugs are defined by American RSDHope as:

SCHEDULE 3 (CLASS 3) DRUGS  have a lower potential for abuse than drugs in the first two categories, accepted medical use, and mild to moderate possible addiction. These drugs include steroids, Low-dose Codeine, and Hydrocodone-based opiods.

SCHEDULE 4 (CLASS 4) DRUGS have an even lower abuse potential than Schedule 3 Drugs, accepted medical use, and limited addiction potential. These include most of the anti-anxiety medications like the numerous Benzodiazepines, Sedatives, sleeping agents, and the mildest of the opiod type medications like Darvon and Talwin.

SCHEDULE 5 (CLASS 5) DRUGS have a low abuse potential, accepted medical use, and a very limited addiction potential. These consist primarily of preparations containing limited quantities of narcotics or stimulant drugs for cough, diarrhea, or pain.
The bill now goes to the House for committee assignment.

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