Can a North Carolina NP prescribe controlled substances without supervision?

No. A North Carolina NP cannot prescribe controlled substances without supervision. Prescribing must occur under a collaborative practice agreement with a primary supervising physician, and any NP prescription is deemed authorized by that supervising physician¹².

Controlled substances (Schedules II–V) may be prescribed only as established in the collaborative practice agreement and when all of the following are met³:

• The NP has an assigned DEA number.
• The DEA number is entered on each controlled-substance prescription.
• Refills are issued consistent with controlled-substance laws and regulations.
• The supervising physician holds the same or greater controlled-substance schedule(s) as the NP.

For “targeted controlled substances,” the NP must personally consult the supervising physician before prescribing when the patient is treated in a pain management facility and therapy will exceed 30 days, and must consult at least every 90 days if prescribing continues for the same patient⁴. For this requirement, “consult” means a meaningful, documented communication sufficient for the supervising physician to determine the prescription is medically indicated⁵.