Texas Administrative Code
Title 22 - EXAMINING BOARDS
Part 11 - TEXAS BOARD OF NURSING
Chapter 222 - ADVANCED PRACTICE REGISTERED NURSES WITH PRESCRIPTIVE AUTHORITY
Section 222.8 - Authority to Order and Prescribe Controlled Substances
Universal Citation: 22 TX Admin Code § 222.8
Current through Reg. 50, No. 13; March 28, 2025
(a) APRNs with full licensure and a valid prescription authorization number are eligible to obtain authority to order and prescribe certain categories of controlled substances. The APRN must comply with all federal and state laws and regulations relating to the ordering and prescribing of controlled substances in Texas, including but not limited to, requirements set forth by the United States Drug Enforcement Administration.
(b) Orders and prescriptions for controlled substances in Schedules III through V may be authorized, provided the following criteria are met:
(1) Prescriptions for a controlled substance
in Schedules III through V, including a refill of the prescription, shall not
exceed a 90 day supply. This requirement includes a prescription, either in the
form of a new prescription or in the form of a refill, for the same controlled
substance that a patient has been previously issued within the time period
described by this subsection.
(2)
Beyond the initial 90 days, the refill of a prescription for a controlled
substance in Schedules III through V shall not be authorized prior to
consultation with the delegating physician and notation of the consultation in
the patient's chart.
(3) A
prescription of a controlled substance in Schedules III through V shall not be
authorized for a child less than two years of age prior to consultation with
the delegating physician and notation of the consultation in the patient's
chart.
(c) Orders and prescriptions for controlled substances in Schedule II may be authorized only:
(1) in a hospital facility-based practice, in
accordance with policies approved by the hospital's medical staff or a
committee of the hospital's medical staff as provided by the hospital's bylaws
to ensure patient safety and as part of care provided to a patient who:
(A) has been admitted to the hospital for an
intended length of stay of 24 hours or greater; or
(B) is receiving services in the emergency
department of the hospital; or
(2) as part of the plan of care for the
treatment of a person who has executed a written certification of a terminal
illness, has elected to receive hospice care, and is receiving hospice
treatment from a qualified hospice provider.
(d) Prescription Monitoring Program (PMP).
(1) APRNs should access and review the
prescription monitoring program (PMP) authorized by Chapter 481, Health and
Safety Code, prior to prescribing any controlled substance for patients being
treated for pain.
(2) APRNs must
access and review the PMP before prescribing opioids, benzodiazepines,
barbiturates, or carisoprodol unless:
(A) the
patient has been diagnosed with cancer or the patient is receiving hospice
care; and
(B) the APRN clearly
notes on the prescription or in the electronic prescription record that the
patient was diagnosed with cancer or is receiving hospice care, as
applicable.
(3) An APRN
will not be subject to disciplinary action if the APRN:
(A) makes a good faith attempt to access and
review the PMP prior to prescribing opioids, benzodiazepines, barbiturates, or
carisoprodol, but is unable to access the information because of circumstances
outside the control of the APRN; and
(B) clearly notes on the patient's
prescription or in the patient's electronic prescription record the APRN's
attempt to access and review the PMP and the circumstances that prevented the
APRN from being able to do so.
(4) Documentation that the review of the PMP
occurred and rationale for prescribing a controlled substance must be included
in the patient's medical record.
(5) This section takes effect September 1,
2019.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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