Prescription Privileges

Prescription privileges refers to the right to prescribe medication. The psychologist prescription privilege (PPP) debate refers to legal and ethical arguments for and against a psychologist prescribing medication. Presently, there are legal avenues by which a psychologist may earn the right to prescribe medication. A psychologist could elect to earn a supplemental degree in such fields as medicine or advanced practice nursing and gain legal authority to prescribe. Extending prescription privilege to psychologists would provide a different and, presumably, less onerous means for a psychologist to gain the right to prescribe. In the United States, granting prescription privileges to psychologists was attempted by various pilot programs in New Mexico, California and, most notably, in the military. Recently, two states, Louisiana and New Mexico, have passed laws to permit additional avenues whereby a psychologist may prescribe medications. As of April 2005, legislatures in 20 states either began studying the impacts of extending PPP or have proposed prescription privilege legislation.

In the United States, only physicians have full prescription privileges. Other professions such as optometry, dentistry, and podiatry are granted limited prescription privileges to prescribe medications that affect the body systems in their area. By the year 2002, approximately 75,000 nonphysicians, including nurse practitioners, midwives, and other clinical specialists had prescription privileges across the United [Page 347]States. In 38 states, pharmacists had the power to prescribe medications.

Those psychologists in favor of granting prescription privileges to psychologists have been represented by the American Psychological Association (APA), an organization whose membership is largely composed of clinicians and independent practitioners. Those opposed to PPP represent two separate camps: those within the psychology profession and those outside of the psychology profession, many of whom are members of the medical establishment.

Psychologists standing in opposition to PPP have been represented by the American Association of Applied and Preventive Psychology (AAAPP), an organization created by psychologists opposing the proliferation of states authorizing PPP, and the Society for a Science of Clinical Psychology. Several physician groups, including the American Psychiatric Association and the American Medical Association (AMA), have also opposed allowing psychologists to have specific training permitting them to prescribe psychotropic medication.