Can Chiropractors Prescribe Medication? What the Scope Rules Say

Summary: in every U.S. state except New Mexico, no. A doctor of chiropractic (DC) can't write a prescription for a legend drug, such as a prescription-strength anti-inflammatory or a muscle relaxant. New Mexico is the one exception, and even there it only applies to chiropractors who complete extra training, register for advanced practice, and stay within a short formulary that three state boards have to agree on. Below is how chiropractic scope is set, what New Mexico allows, where the debate stands in other states, and what chiropractors can do today when a client needs medication.

This article is general information, not legal advice. Scope rules change, so check your state's chiropractic practice act and board rules, and talk to a healthcare attorney before changing how you practice.

Who decides what a chiropractor can do

Chiropractic scope of practice is set state by state. Each state has a chiropractic practice act passed by its legislature, plus rules written by its chiropractic board. Those two documents decide what a DC can and can't do in that state, and they vary a lot.

What most of them share is the starting point: chiropractic has historically been defined as care delivered without drugs or surgery. Some states spell this out. Utah's practice act, for example, lists things a chiropractic physician may not do, including administering drugs that legally require a prescription (outside narrow exceptions), treating cancer, and practicing obstetrics.

A title doesn't change this. Some states use "chiropractic physician," and many DCs use "Dr." Neither one carries prescribing authority on its own.

The New Mexico exception

New Mexico is the only state that gives chiropractors any prescription authority, and it does it through a separate credential.

How it started. In 2008, the New Mexico legislature created the "certified advanced practice chiropractic physician," a tier above the standard chiropractic license with authority to prescribe from an approved list.

What it takes. Under the board's rules (16.4.15 NMAC), a chiropractor applying for advanced practice certification needs:

• 90 clinical and didactic hours covering pharmacology, pharmacognosy, medication administration, and toxicology, from a program approved by both the New Mexico Medical Board and the Board of Chiropractic Examiners
• A passing score on a competency exam from a national credentialing agency, or a graduate degree in a chiropractic clinical specialty
• 10 extra hours of continuing education in those subjects at every renewal

What's on the formulary. The current list (16.4.15.11 NMAC, last amended in 2014) is short and specific:

• Hormones for oral, sublingual, or topical use: estradiol, progesterone, testosterone, and desiccated thyroid
• Cyclobenzaprine (a muscle relaxant)
• Prescription-strength ibuprofen and naproxen
• Several prescription topicals, including NSAIDs like diclofenac and ketoprofen, cyclobenzaprine, and lidocaine
• Homeopathics that require a prescription
• A limited set of injectables: sterile water, sterile saline, Sarapin, caffeine, procaine, epinephrine, and injectable homeopathics
• Glutathione for inhalation

Adding anything to that list requires agreement from the chiropractic board, the medical board, and the pharmacy board. That requirement has been tested in court. In 2013, the New Mexico Court of Appeals set aside an expanded formulary the chiropractic board had adopted, because injectable additions hadn't been approved by the pharmacy and medical boards.

Two more details matter here. Testosterone is a federally controlled substance (Schedule III), and New Mexico's rules require a certified chiropractor whose certification covers controlled substances to register with the DEA first. And chiropractors in New Mexico without advanced certification still have a narrower authority: they can prescribe, administer, and dispense natural substances taken orally or applied topically, as long as the substance isn't classified as a dangerous drug. They can't inject anything.

The catch for everyone else: this authority stops at the New Mexico border. A chiropractor licensed in Texas or Ohio can't earn the New Mexico credential and use it at home.

Other states are debating it

New Mexico may not stay alone forever. Montana came close in 2025:

• HB 500 would have created an optional prescriptive authority endorsement for chiropractors. It failed by a narrow margin in a House vote in March 2025.
• HB 929, a follow-up bill, proposed an optional endorsement limited to noncontrolled, nonscheduled drugs for musculoskeletal care, such as NSAIDs and muscle relaxants. It passed the House but died in a Senate committee in May 2025.

Montana's legislature meets every two years, so the issue may come back in a future session.

The chiropractic profession itself is split on this. In 2013, the Chiropractic Summit, a coalition of more than 40 chiropractic organizations, adopted a statement opposing prescription drug rights for chiropractors. In 2015, the American Chiropractic Association's House of Delegates passed resolutions on a model practice act that included prescriptive authority elements, and created an ACA College of Chiropractic Pharmacology and Toxicology.

Supporters of expanded scope point to access: clients in rural areas or with long waits for a physician appointment. Opponents argue that drug-free care is the core of chiropractic, and raise safety and training concerns. The Montana Medical Association opposed the 2025 bills.

What chiropractors can do around medication today

Not being able to prescribe doesn't mean staying out of the conversation. Within typical scope, chiropractors can:

• Ask about and track current medications. Knowing a client is on a blood thinner, a steroid, or a new prescription can change how you treat them.
• Watch for effects that show up in your room. Dizziness, fatigue, or GI symptoms that limit a session are worth noting and passing along.
• Recommend non-drug care. Adjustments, exercise programs, soft tissue work, modalities, and ergonomic changes are all within scope, and for some clients they reduce how much medication they need.
• Discuss supplements and nutrition, where your state allows it. Rules on recommending or selling vitamins, minerals, and supplements differ by state, so check your board before stocking a shelf.
• Talk about over-the-counter options carefully. General education is different from directing a client to take a specific drug at a specific dose. Where that line sits depends on your state.
• Send the client to a physician when something needs a prescription or a medical workup. Red flags like unexplained weight loss, night pain, or neurological changes call for a medical evaluation, not a workaround.

A note on HIPAA. If your practice is a HIPAA covered entity (most practices that bill insurance electronically are), HIPAA generally allows you to share health information with another provider for treatment purposes. Use secure channels to do it, though. Texting a client's symptoms to a doctor from your personal phone is a common way practices get into trouble. Some states add their own privacy rules on top of HIPAA, so get written authorization from the client when you're unsure.

Where Doc Connect fits

The gap most chiropractors feel isn't legal, it's practical. A client is in your room with a flare that would settle faster with a short course of something a physician might approve in a few minutes. The usual path is to tell them to book with their doctor, which can mean a long wait for an appointment about something you already assessed.

Doc Connect doesn't change your scope of practice, and it isn't a way around it. You still don't prescribe. Here's how it works:

1. You submit a request from your dashboard with your notes on the client.
2. A physician licensed in your client's state reviews it, asks anything they need to, and decides whether to prescribe. If they do, they sign under their own license.
3. Approved prescriptions go to the pharmacy already on the client's file.

The prescribing decision belongs to the physician. Requests are limited to non-controlled medications within the reviewing physician's scope, and controlled substances are blocked at submission. Client data is encrypted at rest and in transit, every action is logged, and Doc Connect signs a business associate agreement (BAA) with every provider on the platform.

Frequently asked questions

Can a chiropractor prescribe muscle relaxers?

Only in New Mexico, and only if the chiropractor holds advanced practice certification. The New Mexico formulary includes cyclobenzaprine. In every other state, muscle relaxants are outside chiropractic scope.

Can a chiropractor prescribe anti-inflammatories?

Prescription-strength NSAIDs follow the same rule: New Mexico advanced practice chiropractors can prescribe ibuprofen and naproxen at prescription strength, plus some topical NSAIDs. Elsewhere, no. Whether a chiropractor can recommend an over-the-counter anti-inflammatory depends on state rules.

Can chiropractors give injections?

In most states, no. New Mexico allows certified advanced practice chiropractors to inject a short list of substances, such as sterile saline, procaine, and Sarapin. If you're outside New Mexico and considering injections of any kind, including vitamin injections, check with your state board first.

Does "chiropractic physician" mean a DC can prescribe?

No. Some states use the title, but it doesn't carry prescribing authority. Authority comes from the practice act and board rules, not the title.

Can chiropractors order lab tests or imaging?

Many state practice acts allow chiropractors to take or order X-rays, and some allow ordering lab work or advanced imaging. That's a separate question from prescribing and varies widely by state.

Is my state likely to change its rules soon?

Bills come up from time to time, as Montana's 2025 bills show, but none outside New Mexico have become law. If you want to follow it, your state chiropractic association and board meeting minutes are the best places to watch.

Sources: New Mexico Administrative Code, 16.4.15 NMAC: Chiropractic Advanced Practice Certification Registry, New Mexico Register, 16.4.15 NMAC amendment (2022), N.M. Court of Appeals, International Chiropractors Ass'n v. N.M. Board of Chiropractic Examiners (2013), New Mexico Legislature, HB 14 (2009), Utah Legislature, Chiropractic Physician Scope of Practice Amendments (SB 229, 2018), Montana Legislature, HB 929 (2025) bill text, BillTrack50, Montana HB 929 status, Dynamic Chiropractic, Prescriptive Authority for Montana DCs, Chiropractic Economics, ACA Clarifies Scope of Practice Policy and New College of Pharmacology and Toxicology (2015), Dynamic Chiropractic, The Drug Issue: Dead and Buried.