Who can prescribe morphine, by country

• 250 mg Morphine prescribed per clinic per day after oncologists were trained, Armenia, 2012¹⁵⁶

No single physician could prescribe alone under the procedures described. Where oncologists were trained, their daily morphine prescribing rose several-fold.¹⁵⁶

OpenCan a single physician now prescribe, and is any nurse role permitted?

General practitioners, working with community pharmacists, prescribe and coordinate end-of-life medicines at home. Endorsed nurse practitioners may prescribe, and a rural pilot judged prescribing authority essential to a nurse practitioner-led palliative model.^161,164

OpenWhat controlled-drug prescribing rights do nurse practitioners hold for palliative care in each state?

Bangladesh sets no legal limit on opioid quantity or prescription length. Prescribing is restricted by physician level and requires a license, which the authors of a 2022 Dhaka-area survey of palliative care staff call the main barrier. In a 2014 national physician survey, 53% were unaware of the Bangladesh Narcotics law, 1990.^370,371

OpenWhich physician grades can hold an opioid prescribing license, and can district or primary care doctors prescribe morphine?

Only physicians and dentists with a special local registration may prescribe scheduled opioids, and pharmacists may not accept emergency telephone prescriptions.²³²

OpenHas prescribing authority been extended beyond physicians and dentists?

Since 2012, nurse practitioners, midwives and podiatrists may prescribe controlled medications under federal law. Nurse practitioner scope includes end-of-life care, and general practitioners write most palliative opioid prescriptions in provincial data.^216,217

OpenHow often do nurse practitioners prescribe opioids in palliative care since 2012?

Narcotics must be prescribed by a physician who has had special training and is authorized by their hospital, on a national red paper prescription, per a 2016 hospital report. China has no nationwide nurse prescribing rights, only regional pilots. In one province, fewer than a third of primary care hospice services stocked strong opioids in 2023.^268,269,180

OpenWhat does the current national regulation require to qualify as a narcotics prescriber, and may primary care physicians prescribe?

Opioid prescriptions in the national dispensing study came from medical and surgical specialties. No non-physician prescribing category was reported.⁸⁶

OpenDoes any nurse or non-physician cadre hold authority to prescribe oral morphine?

• 26 percent Patients needing strong opioids adequately supplied by one weekly prescription, Egypt, 2011⁹⁰

Prescribing is physician-led. The cap means most patients needing strong opioids need repeated prescriptions within a week. A regional cancer centre reported no institutional end-of-life policy at all.^90,91

OpenMay a general physician outside a cancer centre prescribe oral morphine, and on what terms?

Only physicians may prescribe morphine, even in rural facilities with no physician, which nurses contrast with Uganda and Tanzania.¹³⁵

OpenHas any move been made to extend prescribing to nurses or health officers?

• 38 percent Surveyed primary care physicians who avoid prescribing opioids, Georgia, 2018¹⁵³
• 50 percent, approximate Primary care doctors in palliative programmes authorised to prescribe morphine, Georgia, 2024¹⁵⁴

Any physician may now prescribe for terminal patients, including rural primary care doctors. In practice many avoid it: few know the liberalised rules, and those who follow them are investigated by legal authorities several times more often. Only about half of primary care doctors in palliative programmes hold prescribing authorisation.^153,154

OpenWhat training is required for authorisation, and has enforcement practice changed?

Only physicians, dentists and veterinarians may prescribe opioids. Hospital palliative consultation services mostly recommend opioids while attending physicians prescribe and carry legal responsibility. Nurses help manage many specialist home teams but have no documented prescribing role.^172,173,174

OpenDo home palliative nurses adjust opioid doses under delegation, and how is that governed?

• 10 days Hands-on training required before a physician may prescribe oral morphine, Kerala, Kerala, India, 2015⁵¹

The amendment created no new prescriber class. A registered medical practitioner still signs, but for essential narcotic drugs must additionally have completed training in pain relief and palliative care. Stocking and dispensing sit with the recognised medical institution, not the individual.^50,51

OpenHow many recognised medical institutions are registered nationally?

Doctors in Indonesia need a license to prescribe opioids, and the ACE study authors describe the licensing procedure as complex. They also report that opioid prescriptions are limited to a few days and that each prescription carries burdensome reporting.³⁷⁴

OpenWhich doctors (specialists, general practitioners, primary care physicians) can obtain the license, and has the rule changed since 2018?

Providers interviewed in Iran reported that opioids reach patients with incurable disease at hospitals or through the national Food and Drug Administration only after a doctor's prescription. Cancer patients go monthly to the Food and Drug Administration to collect drugs prescribed by a specialist. Based on stakeholder interviews; no legal text was read.³²⁶

OpenWhich physician categories (specialists, general practitioners, family physicians) may legally write opioid prescriptions, and may nurses do so?

Only physicians may prescribe opioids, and a narcotics license is needed for narcotic opioids. Before 2016, physicians could bill the insurance fee for basic palliative care with opioid prescribing whether or not they had palliative training. Lack of professional training is named as the main barrier to opioid availability.^201,270

OpenDid the post-2016 training condition change prescribing?

A 2024 continental review lists Kenya among the African countries where nurses may prescribe morphine. The same review's listing proved overstated for Malawi and Tanzania when checked against country-specific sources, so the Kenyan permission is uncorroborated. The Clinical Officers Council has recognised palliative medicine as a licensed specialty, and the Nursing Council recognises a palliative nurse practitioner diploma.^{63,60,103,100}

OpenDoes Kenyan law give nurses independent authority to prescribe morphine, and under what training and licensing conditions?

Oncologists, surgeons and family physicians prescribe. The medical and nursing councils have endorsed nurse prescribing, but in practice nurses prescribe only in emergencies under an informal ministry agreement, because the statute was never changed.¹⁰³

OpenHas the nursing council formally defined nurse prescribing authority, and does the statute now support it?

Hospital palliative care is led by resident or visiting palliative physicians or trained medical officers, and domiciliary teams of nurses and medical assistants work under a family health physician. Community doctors often lack access to opioids.⁴⁷

OpenIs opioid prescribing legally restricted to registered medical practitioners, and is it tied to the specialty credential?

Since 2015, providers obtain opioid prescriptions through a federal electronic system, and each prescription carries a QR code that encrypts the prescriber's personal data. The limit on prescriptions per provider rose from 50 to 200.⁹⁵

OpenWhich professions may legally prescribe group 1 opioids in Mexico, and must prescribers hold a specific COFEPRIS registration?

• 8,000 workers, lower bound Mid-level health workers delivering most rural services, Nepal, 2018⁵⁴

Prescribing is limited to registered medical practitioners. Mid-level health workers, who deliver most rural care, state they are not permitted to prescribe morphine and would do so with training and legal authorisation, citing Uganda.^52,54

OpenHas any reform since 2018 extended morphine prescribing to nurses or mid-level health workers?

A 2025 review reports that the controlled medicines policy allows community health officers and extension workers to prescribe controlled medicines, morphine included, at primary health centres where no doctor is present. A separate 2025 review of addiction treatment reports prescribing of controlled opioids limited to doctors and dentists, which may reflect that narrower use.⁶⁵

OpenDoes the non-physician authority exist in the policy text, and with what training conditions? The policy itself was not read.

• Unknown people Practicing palliative specialists nationally, Pakistan, current²⁵

OpenIs any nurse or clinical officer prescribing authority available under current law?

Restrictive drug enforcement rules, too few licensed prescribers and bureaucracy are reported to hinder pain management, especially in rural areas. No non-physician prescribing authority was found.⁷⁹

OpenWhat does the dangerous drugs licence require of a prescriber, and did the special prescription form requirement change?

The old law restricted prescribing authority. The 2005 law was designed to simplify prescribing, with national courses for doctors and pharmacists.^191,190

OpenWhich physician groups, such as family doctors, may prescribe strong opioids today?

• 60 staff Staff trained in morphine procurement and prescribing, national initiative, Rwanda, 2014⁵⁷

The only prescriber detail in a source read in full: the national morphine prescribing initiative trained doctors and pharmacists, who made morphine first-line for severe pain. The study recommends nurse prescribing across all four countries but does not report it as Rwandan law.⁵⁷

OpenDo nurses or community health workers hold any prescribing authority, or do they only deliver doses a physician has prescribed? Press accounts do not draw this line.

• 62.90 percent Surveyed physicians with access to the national narcotics prescribing platform, Saudi Arabia, 2025⁸⁸

Physicians across oncology, surgical oncology and acute care prescribe for cancer pain. No non-physician prescribing authority was found, and access to the prescribing platform, not legal scope, limited who could prescribe in the hospital studied.⁸⁸

OpenMay any nurse practitioner or clinical pharmacist prescribe or titrate opioids?

Nurses may hold a permit to prescribe, but a 1984 regulation still in force limits them to lower schedules, excluding morphine. The nursing council has not authorised Schedule 5 or 6 prescribing.¹³²

OpenHow many nurses hold prescribing permits, and has the schedule limit been lifted?

Authorized healthcare professionals may prescribe opioids under the Narcotics Control Act.⁷⁹

OpenWhich professions count as authorized, and have nurses been added?

Nurses may prescribe a limited set of medicines under physician authorization or supervision. No source addresses who may prescribe opioids for palliative care.²²⁴

OpenDoes nurse prescribing extend to any opioids?

• 23.80 percent Surveyed physicians who had prescribed morphine for palliative care, Sri Lanka, 2024⁷⁴
• 10.20 percent Public health nurses reporting morphine administration, Sri Lanka, 2025⁷⁵

Prescribing is limited to physicians. Public health nurses make palliative home visits and administer prescribed morphine but are not legally permitted to prescribe. Free provision has not widened prescribing.^75,74

OpenIs there any protocol under which a nurse may prescribe or titrate morphine?

A 2024 continental review lists Tanzania both among countries where nurses may prescribe morphine and among those requiring a physician's special licence, without reconciling the two. A detailed case study found nurses trained to deliver morphine but no independent nurse prescribing.^63,100

OpenDoes any nurse prescribing authority exist in law, and is it used?

• 75.60 percent Government hospitals prohibiting advanced practice nurses from prescribing oral opioids, Thailand, 2012¹¹¹

Any physician in a government hospital may prescribe oral morphine on clinical judgement without special registration, which the survey authors call more permissive than some European rules. Most hospitals bar advanced practice nurses from prescribing, and physicians and regulators showed knowledge and attitude gaps.^111,113

OpenHas district palliative policy defined a nurse prescribing scope since 2012?

A clinical officer or nurse holding a certificate in specialist palliative care may prescribe and supply the listed morphine preparations, under the 2004 narcotic analgesic regulations.^12,34

Doctors, and nurses and pharmacists who complete prescribing training, may prescribe. In England, most nurse and pharmacist prescribers in community palliative care prescribe controlled drugs, though many specialist nurses are not trained as prescribers because of cost and lack of employer support.^245,246

OpenHow many non-medical prescribers actively prescribe controlled drugs for palliative care nationally?

State scope-of-practice laws restrict nurse practitioners and often require physician supervision. Evidence on whether independent practice changes opioid prescribing conflicts, and none of it is specific to palliative care.^258,259

OpenMay nurse practitioners and physician assistants prescribe the strongest opioids for hospice patients in each state?

• 8 percent Physicians who felt adequately trained in palliative care before training, Vietnam, 2014¹⁴⁸

Prescribing remains with physicians. Training was extended to nurses, but no source reports nurses gaining authority to prescribe; the reform widened the dispensing channel, not prescriber scope.^147,148

OpenHas any instrument given nurses or pharmacists authority to prescribe opioids?

A study at a Lusaka tertiary hospital describes doctors as the morphine prescribers. A 2024 review lists ten African countries where nurses may prescribe morphine, and Zambia is not among them. A four-country hospital program recommended nurse prescribing to widen capacity. No source read states the legal rule.^187,63,57

OpenMay nurses or clinical officers prescribe morphine, or only doctors?