Drug - Naturopathy Jurisdictional Review · Naturopathic Physicians of British Columbia Prescribing authority pending the approval of by-laws created by the College board. NDs are

55 St. Clair Avenue West

Suite 806 Box 18 Toronto, Ontario, Canada M4V 2Y7

Toll-Free: 1-888-377-7746 Telephone: 416-326-1550

Fax: 416-326-1549 Web: www.hprac.org

Prescribing and Use of Drugs by Non-Physician Health Professionals:

A Jurisdictional Review of the Profession of Naturopathy

November 2008

Non Physician Prescribing and Use of Drugs Jurisdictional Review – Profession of Naturopathy November, 2008

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1) Authority to Prescribe and/or Administer Drugs in Canadian Jurisdictions, by profession

Province (Regulatory Body)

Prescribe and/or

Administration of drugs

Framework Authority Standard of Practice/Guidelines/Policies

Use of list/ class

Ontario Board of Directors of Drugless Therapy1

No prescribing but can administer a prescribed substance

Naturopathic Doctors are subject to the Drugless Practitioners Act2, 1990, NDs are also a regulated profession under the umbrella Regulated Health Professions Act, 1990,3. The Naturopathy Act, 20074, is yet to be enacted.

Scope of Practice5

3. The practice of naturopathy is the assessment of diseases, disorders and dysfunctions and the naturopathic diagnosis and treatment of diseases, disorders and dysfunctions using naturopathic techniques to promote, maintain or restore health. 2007, c. 10, Sched. P, s. 3.

Authorized acts

4. (1) In the course of engaging in the practice of naturopathy, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to perform the following:

1. Putting an instrument, hand or finger beyond the labia majora but not beyond the cervix.

2. Putting an instrument, hand or finger beyond the anal verge but not beyond the rectal-sigmoidal junction.

3. Administering, by injection or inhalation, a prescribed substance.

4. Performing prescribed procedures involving moving the joints of the spine beyond the individual’s usual physiological range of motion using a fast, low amplitude thrust.

5. Communicating a naturopathic diagnosis identifying, as the cause of an individual’s symptoms, a disease, disorder or dysfunction that may be identified through an assessment that uses naturopathic techniques.

6. Taking blood samples from veins or by skin pricking for the purpose of

The Board issued a policy document outlining educational and practice standards for parenteral therapy. This policy specifies the requirements for preparing the injection sites, infection control, emergency preparedness and handling, storage of materials and the procedure room. Prerequisite courses for parental therapy are outlined in the document. APPENDIX II of the policy document outlines Parental Therapy Injectables, which are substances approved for use in Parenteral Therapy, and disallows the use of substances not included in the list. The list includes 14 vitamins, 17 minerals, 24 mixed amino acids, 4 botanicals, 3 immune agents, 8 miscellaneous substances, 3

1 www.boardofnaturopathicmedicine.on.ca 2 http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_90d18_e.htm3 http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_91r18_e.htm4 This is not yet in force: http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_07n10_e.htm5 This is not yet in force: Naturopathy Act, 2007

http://www.e-laws.gov.on.ca/html/statutes/french/elaws_statutes_07n10_f.htm#s3

http://www.e-laws.gov.on.ca/html/statutes/french/elaws_statutes_07n10_f.htm#s4s1

http://www.e-laws.gov.on.ca/html/statutes/french/elaws_statutes_07n10_f.htm#s4s1

http://www.boardofnaturopathicmedicine.on.ca/

http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_90d18_e.htm

http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_91r18_e.htm

http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_07n10_e.htm


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Prescribe and/or



Use of list/ class

prescribed naturopathic examinations on the samples. 2007, c. 10, Sched. P, s. 4 (1).

Act does not authorize practice of medicine6

7. Nothing in this Act or the regulations authorizes a person, not being so expressly authorized under a general or special Act of the Legislature, to prescribe or administer drugs for use internally or externally or to use or direct or prescribe the use of anaesthetics for any purpose whatsoever or to practise surgery or midwifery. R.S.O. 1990, c. D.18, s. 7.7

superficial intramuscular injectables and 3 deep intramuscular injectables. The Board has also issued a policy document outlining the safe storage, handling and preparation or compounding of bulk and finished medicines used for treatment. This document describes the expected standard of practice of preparing and compounding naturopathic medicine.

Alberta

College of Naturopathic Doctors of Alberta8

No direct authority to prescribe or administer

Until regulations are passed, NDs remain unregulated in this jurisdiction.

Scope of Practice9

3 In their practice, naturopathic practitioners do one or more of the following:

(a) promote health, prevent illness and treat disease by using natural therapies and substances that promote the body’s ability to heal,

(b) focus on the overall health of the individual on the basis of naturopathic assessment and common diagnostic procedures, and

(c) provide restricted activities authorized by the regulations.

---------------------------------------------

6 Drugless Practitioners Act, R.S.O. 1990, CHAPTER D.18, Government of Ontario, http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_90d18_e.htm7 Drugless Practitioners Act, R.S.O. 1990, CHAPTER D.18, Government of Ontario, http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_90d18_e.htm8 This is not yet in force: http://www.cndacms.com/9 This section not yet in force: Health Professions Act, R.S.A. 2000, c. H-7, Schedule 14, Government of Alberta, http://www.canlii.org/ab/laws/sta/h-7/20080818/whole.html 10 Liz Yorke and Associates’ telephone discussions with Dr. Mike Nowazek & with Dr. Bruce Lofting, of the Alberta Association of Naturopathic Practitioners.

http://www.e-laws.gov.on.ca/html/statutes/french/elaws_statutes_90d18_f.htm#s7



http://www.cndacms.com/


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Prescribe and/or



Use of list/ class

NDs are registered by Alberta Association of Naturopathic Practitioners (to be regulated under the Health Professions Act, once regulations are approved and its schedule under the Act comes into effect). NDs in Alberta are concerned about losing ability to prescribe and dispense natural medicines that require a prescription, like bio-identical hormones, antibiotics, and anti-fungals & amino. 10

British Columbia College of Naturopathic Physicians of British Columbia

Prescribing authority pending the approval of by-laws created by the College board.

NDs are subject to the Naturopathic Physicians Regulation, of the Health Professions Act.

Scope of Practice "naturopathic medicine" means the art of healing by natural methods or therapeutics, including the first aid treatment of minor cuts, abrasions and contusions, bandaging, taking of blood samples, and the prescribing or administering of authorized preparations and medicines. 11

Limits or conditions on services 12

6 No registrant may (a) prescribe or administer drugs for internal or external use other than the preparations and medicines specified in bylaws made by the board and approved by the Lieutenant Governor in Council, (b) use or administer anaesthetics for any purpose, or (c) practise surgery.

Manitoba Manitoba Naturopathic Association


NDs are regulated by the Naturopathy Act, 1987.

Scope of Practice "naturopathy" means a drugless system of therapy that treats human injuries, ailments, or diseases, by natural methods, including any one or more of the physical, mechanical, or material, forces or agencies of nature, and employs as auxiliaries for such purposes the use of electro-therapy, hydro-therapy, body manipulations, or dietetics; (« naturopathie »)13

11 Naturopathic Physicians Regulation, B.C. Reg. 282/2008, s.1, Health Professions Act, Government of British Columbia, http://www.qp.gov.bc.ca/statreg/reg/H/HealthProf/282_2008.htm12 Ibid. s.6 13 The Naturopathic Act, C.C.S.M. c. N80, Government of Manitoba, http://www.canlii.org/mb/laws/sta/n-80/20080818/whole.html

http://www.qp.gov.bc.ca/statreg/reg/H/HealthProf/282_2008.htm


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Prescribe and/or



Use of list/ class

Certain practices prohibited

24 Nothing in this Act or the regulations authorizes any person to prescribe or administer drugs for use internally or externally, or to use or direct or prescribe the use of anaesthetic for any purpose whatsoever, or to practise surgery or midwifery. 14

Nova Scotia


NDs are regulated by the Act Respecting Naturopathic Doctors (also known as the Naturopathic Doctors Act, 200815), which provides a scope of practice and title protection for NDs but does not comment on prescribing or administering.

Scope of Practice 16

(e) "naturopathy" means the assessment of diseases, disorders and dysfunctions and the naturopathic diagnosis and treatment of diseases, disorders and dysfunctions using naturopathic techniques to promote, maintain or restore health.

Saskatchewan


NDs are regulated under the Naturopathy Act, 197817

Scope of Practice18

e) "naturopathy" means the art of healing by natural methods as taught in recognized schools of naturopathy.

14 Ibid. s.24 15 Naturopathic Doctors Act, S.N.S. 2008, c. 5, Government of Nova Scotia, http://www.canlii.org/eliisa/highlight.do?text=naturopathy&language=en&searchTitle=Nova+Scotia&path=/ns/laws/sta/2008c.5/20080818/whole.html16 Ibid. s.3 17 Naturopathy Act, R.S.S. 1978, c. N-4, Government of Saskatchewan, http://www.canlii.org/sk/laws/sta/n-4/20080818/whole.html18 Ibid. s.2

http://web2.gov.mb.ca/laws/statutes/ccsm/n080f.php#24

http://www.canlii.org/eliisa/highlight.do?text=naturopathy&language=en&searchTitle=Nova+Scotia&path=/ns/laws/sta/2008c.5/20080818/whole.html

http://www.canlii.org/sk/laws/sta/n-4/20080818/whole.html


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Prescribe and/or



Use of list/ class

Right to practise only naturopathy19

10 Nothing in this Act or the bylaws shall authorize any person to prescribe or administer drugs for use internally or externally, or to use or direct or prescribe the use of anaesthetics for any purpose whatsoever, or to treat venereal disease or a communicable disease as defined in The Public Health Act, 1994, or to practise medicine, surgery or midwifery, or to use any method of treatment other than naturopathy.

19 Ibid. s.10


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2) Authority to Prescribe and/or Administer Drugs in Non-Canadian, Non-US jurisdictions Naturopathy: Jurisdictions other than Continental North America The Naturopathy sector in North America consistently states that there is no jurisdiction in the world with similar education, training, and entry to practice requirements to Canada and the United States. To practice in Canada or the US, individuals educated in “naturopathy” in countries other than Canada and the US are required to have their credentials assessed by a naturopathic medical education program accredited by the Council of Naturopathic Medical Education (CNME), and are generally subsequently required to upgrade through on-site registration and successful completion of additional education before taking the qualifying Naturopathic Physicians Licensing Examination (NPLEX). This process is consistent in both Canada and the US. Regardless of the above, the following information about Naturopathy is provided for comparison purposes. Jurisdiction Regulation Authority to prescribe

and/or use drugs References/Sources

Australia Voluntary self-regulation No Australian Naturopathic Practitioners Association, www.anpa.asn.auFrance Not regulated

Voluntary registration without regulation, through a national body.20

Private websites have produced high level pictographs on the state of regulation of Naturopathy in France and throughout Europe. 21

Information about the practice of naturopathy in France is available at www.ecole-naturopathie.fr/situation

Germany Regulated by German law

No The Relevance of Homeopathic Medicinal Products for German Naturopathic Practitioners within the European Context, Arne Kruger, Deputy Spokesman of the Committee on Medicinal Products of German Naturopathic Practitioners – BfArM in Dialogue: Homeopathic Medicinal Products – Perspectives in Europe, 18 June, 2007, Bonn, Germany

New Zealand NDs are not regulated in this jurisdiction. The New Zealand Society of Naturopaths22 and other associations have advocated for registration and/or regulation.

No Information about the Ministerial Advisory Committee on Complementary and Alternative Health is available at www.newhealth.govt.nzmaccah/regulation Information about the Health Practitioners Competence Assurance Act 2003 is available as www.moh.govt.nz

Switzerland Regulated by canton No Information about the School of Traditional European Naturopathy is available at http://64.233.179.104 Information about the Association des practiciens en therapies naturelles is available at

20 http://cenatho.free.fr/8_LAFENAHMAN.html21 http://cenatho.free.fr/europe_franceed.htm22 http://www.naturopath.org.nz/about.html

http://www.anpa.asn.au/

http://www.ecole-naturopathie.fr/situation

http://www.newhealth.govt.nzmaccah/regulation

http://www.moh.govt.nz/

http://64.233.179.104/

http://cenatho.free.fr/8_LAFENAHMAN.html

http://cenatho.free.fr/europe_franceed.htm

http://www.naturopath.org.nz/about.html


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www.aptn.chUnited Kingdom

Voluntary self-regulation NDs are not regulated in this jurisdiction. Private bodies exist23 to provide a registry for NDs, but do not govern them.

No Information about the General Council and Register of Naturopaths is available at www.naturopathy.org.ukEmail correspondence with Secretary and Registrar of the General Council and Register of Naturopaths (August 2008)

23 General Council and Register of Naturopaths, http://www.naturopathy.org.uk/default.asp

http://www.aptn.ch/

http://www.naturopathy.org.uk/

http://www.naturopathy.org.uk/default.asp


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3) Authority to Prescribe and/or Administer Drugs in United States Jurisdictions There are eighteen states that license NDs (as of July 2008): Alaska, Arizona, California, Connecticut, Hawaii, Idaho, Kansas, Maine, Minnesota, Montana, New Hampshire, Oregon, Utah, Vermont and Washington as well as the District of Columbia and the US Territories of Puerto Rico and the US Virgin Islands.24

From a 2007 report25 submitted to the California legislature by the Bureau of Naturopathic Medicine, California Department of Consumer Affairs: As the scope of practice for NDs varies from state to state, so do the laws and regulations regarding prescribing. Of the 13 other states that license NDs, 9 of those states allow NDs to prescribe independently, without any MD supervision or protocol. Only one state, Kansas, which instituted licensure in 2003, requires MD supervision, and Maine requires collaboration with a physician for one year prior to independent prescribing.

State ND Licensure Enacted # of Current Active NDs Prescriptive Authority MD Supervision Required

Alaska 1986 40 No No

Arizona 1935 375 Yes No

Connecticut 1920 210 No No

Hawaii 1925 85 Yes No

Idaho 2005 8 Yes No

Kansas 2003 11 Yes Yes

Maine 1995 27 Yes 1 year

Montana 1991 67 Yes No

New Hampshire 1994 57 No No

Oregon 1927 715 Yes No

Utah 1997 18 Yes No

Vermont 1995 117 Yes No

Washington 1919 802 Yes No

24 Canadian Association of Naturopathic Doctors, http://www.cand.ca/index.php?4025 http://www.naturopathic.ca.gov/formspubs/formulary_report.pdf

http://www.cand.ca/index.php?40

http://www.naturopathic.ca.gov/formspubs/formulary_report.pdf


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The US Department of Justice, Drug Enforcement Administration (DEA) describes a mid-level practitioner as an individual practitioner other than a physician, dentist, veterinarian or podiatrist who is licensed, registered or otherwise permitted by the United States or the jurisdiction in which he/she practices, to dispense a controlled substance in the course of professional practice - the list of mid-level professions includes the naturopathic physician. On its web site, www.deadiversion.usdoj.gov/drugreg/practitioners/index.htn1, the DEA identifies states which authorize naturopathic physicians to prescribe controlled substances and the related schedules. State Prescribe

and/or administer drugs


Use of list/class

Alaska Department of Commerce, Community & Economic Development


NDs are regulated under the Naturopath Statutes26, and Naturopath Regulations27

Under the current statues (3) “naturopathy” means the use of hydrotherapy, dietetics, electrotherapy, sanitation, suggestion, mechanical and manual manipulation for the stimulation of physiological and psychological action to establish a normal condition of mind and body; in this paragraph, “dietetics” includes herbal and homeopathic remedies. 28

Restrictions on practice of naturopathy. A person who practices naturopathy may not (1) give, prescribe, or recommend in the practice (A) a prescription drug; (B) a controlled substance; (C) a poison; (2) engage in surgery; (3) use the word “physician” in the person’s title.29

-----------------------------------------

Under the proposed Naturopaths bill (March, 2008)30, NDs would gain significant prescribing rights, along with a more complete scope of practice statement, permission to perform minor surgery and regulation under a professional board. Changes include the following:

26 Naturopath Statutes, 2008, (08.45), State of Alaska http://www.dced.state.ak.us/occ/pub/NaturopathyStatutes.pdf27 Ibid. 28 Naturopath Statues, Sec. 08.45.200 29 Naturopath Statues, Sec. 08.45.050 30 Proposed bill to the Naturopathic Statues (2008), http://www.legis.state.ak.us/PDF/25/Bills/SB0107C.PDF

http://www.deadiversion.usdoj.gov/drugreg/practitioners/index.htn1

http://www.dced.state.ak.us/occ/pub/NaturopathyStatutes.pdf

http://www.legis.state.ak.us/PDF/25/Bills/SB0107C.PDF


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State Prescribe and/or administer drugs


Use of list/class

Scope of practice as a naturopath31

(a) A naturopath may 10 (1) use physical examinations consistent with naturopathic medical 11 education and training for diagnostic purposes; and 12 (2) perform and administer therapies consistent with naturopathic 13 medical education and training. 14 (b) A naturopath who has practiced naturopathy for at least five years may 15 (1) order or conduct medical imaging and laboratory examinations 16 consistent with naturopathic medical education and training; 17 (2) under a prescription endorsement issued under AS 08.45.056, 18 administer and prescribe prescription drugs and medical devices as approved for use 19 by naturopaths by the board; and 20 (3) subject to (c) of this section, perform minor surgery. 21 (c) Minor surgery may be performed by a naturopath licensed under this 22 chapter only if the naturopath has submitted proof satisfactory to the board that the 23 naturopath has completed at least 1,200 hours of training in minor surgery under the 24 supervision of a licensed physician, physician's assistant, or nurse practitioner. Prescription endorsement. (a) The board shall request the 10 department to issue a prescription endorsement to a naturopath licensed under this 11 chapter who has practiced naturopathy for five years, who is qualified under 12 AS 08.45.045(b), and who has submitted proof satisfactory to the board that the 13 naturopath has 14 (1) successfully completed at least 60 hours of education from a 15 program approved by the board; 16 (2) met other requirements establishing proof of competency and 17 professional qualifications that the board considers necessary to ensure the continued 18 protection of the public; and 19 (3) obtained the appropriate registration issued by the Federal Drug

Arizona

Prescribe and Administer

NDs are regulated under Chapter 14,

Under the Statues33

15. "Drug" has the same meaning prescribed in section 32-1901 but does not include: The Board requires all naturopathic physicians to apply for a Certificate to

31 Proposed bill to the Naturopathic Statues (2008), http://www.legis.state.ak.us/PDF/25/Bills/SB0107C.PDF

http://www.legis.state.ak.us/PDF/25/Bills/SB0107C.PDF


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Use of list/class

Naturopathic Physicians Medical Board

Title 32 (Professions and Occupations) of the Arizona Revised Statutes32.

(a) Intravenous administration of legend drugs, except for: (i) Vitamins, chelation therapy and drugs used in emergency resuscitation and stabilization. (ii) Minerals.

(b) Controlled substances listed as schedule I or II controlled substances as defined in the federal controlled substances act of 1970 (21 United States Code section 802), except morphine and any homeopathic preparations that are also controlled substances.34

28. "Practice of naturopathic medicine" means a medical system of diagnosing and treating diseases, injuries, ailments, infirmities and other conditions of the human mind and body including by natural means, drugless methods, drugs, non-surgical methods, devices, physical, electrical, hygienic and sanitary measures and all forms of physical agents and modalities. 32-1581. Dispensing of natural substances, drugs and devices; conditions; civil penalty; dispensing minerals; definitionsA. A doctor of naturopathic medicine may dispense a natural substance, drug or device to a patient for a condition being diagnosed or treated by the doctor if: 1. The doctor is certified to dispense by the board and the certificate has not been suspended or revoked by the board. 2. The natural substance, drug or device is dispensed and properly labeled with the following dispenser information:

(a) The dispensing doctor's name, address and telephone number and a prescription number or other method of identifying the prescription. (b) The date the natural substance, drug or device is dispensed.

Dispense.

32 Title 32 - Professions and Occupations, Chapter 14, Naturopathic Medicine, Arizona Revised Statutes, State of Arizona, http://www.azleg.gov/ArizonaRevisedStatutes.asp?Title=3233 Title 32 - Professions and Occupations, Chapter 14, Naturopathic Medicine, Arizona Revised Statutes, State of Arizona, http://www.azleg.gov/ArizonaRevisedStatutes.asp?Title=3234 Title 32 - Professions and Occupations, Chapter 14, s.32-1501 Naturopathic Medicine, Arizona Revised Statutes, http://www.azleg.gov/ArizonaRevisedStatutes.asp?Title=32 35 Title 32 - Professions and Occupations, Chapter 14, s.32-1901 Pharmacy, Arizona Revised Statutes, http://www.azleg.gov/ArizonaRevisedStatutes.asp?Title=3236 http://www.npbomex.az.gov/UserFiles/Notice%20to%20AZ%20Pharmacists.doc 37 http://www.naturopathic.ca.gov/formspubs/formulary_report.pdf

http://www.azleg.gov/ArizonaRevisedStatutes.asp?Title=32




http://www.npbomex.az.gov/UserFiles/Notice%20to%20AZ%20Pharmacists.doc



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(c) The patient's name. (d) The name and strength of the natural substance, drug or device, directions for proper and appropriate use and any cautionary statements for the natural substance, drug or device. If a generic drug is dispensed the manufacturer's name must be included.

3. The dispensing doctor enters into the patient's medical record the name and strength of the natural substance, drug or device dispensed, the date the natural substance, drug or device is dispensed and the therapeutic reason. 4. The dispensing doctor keeps all prescription-only drugs, controlled substances and prescription-only devices in a secured cabinet or room, controls access to the cabinet or room by a written procedure and maintains an ongoing inventory of its contents. B. Except in an emergency, a doctor of naturopathic medicine who dispenses a natural substance, drug or device without being certified to dispense by the board is subject to a civil penalty by the board of not less than three hundred dollars and not more than one thousand dollars for each transaction and may be prohibited from further dispensing for a period of time as determined by the board. C. Before dispensing a natural substance, drug or device pursuant to this section, the treating doctor shall give the patient or the patient's legal guardian a written prescription and must inform the patient or the patient's legal guardian that the prescription may be filled by the prescribing doctor or the pharmacy of the patient's choice. If the patient chooses to have the medication dispensed by the doctor, the doctor must retrieve the written prescription and place it in a prescription file kept by the doctor. D. A doctor of naturopathic medicine shall provide direct supervision of a nurse or attendant involved in the dispensing process. For the purposes of this subsection, "direct supervision" means that a doctor of naturopathic medicine is present and makes the determination as to the necessary use or the advisability of the natural substance, drug or device to be dispensed. E. The board shall enforce this section. The board shall adopt rules regarding the dispensing of a natural substance, drug or device including the labeling, record keeping, storage and packaging of natural substances that are consistent with the requirements of chapter 18 of this title. The board


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may conduct periodic inspections of dispensing practices to assure compliance with this section and applicable rules. F. This section does not prevent a licensed practical or professional nurse employed by a doctor of naturopathic medicine from assisting in the delivery of natural substances, drugs and devices in accordance with this chapter. G. Before prescribing or dispensing a mineral to a patient, the treating physician shall perform necessary clinical examinations and laboratory tests to prevent toxicity due to the excessive intake of magnesium, calcium and other minerals. The board shall adopt rules necessary for the safe administration of minerals. These rules shall require prior certification of a physician who prescribes or dispenses minerals to a patient. H. For the purposes of this section: 1. "Device" means an appliance, apparatus or instrument administered or dispensed to a patient by a doctor of naturopathic medicine. 2. "Dispense" means the delivery by a doctor of naturopathic medicine of a natural substance, drug or device to a patient and only for a condition being diagnosed or treated by that doctor, except for free samples packaged for individual use by licensed manufacturers or repackagers, and includes the prescribing, administering, packaging, labeling and security necessary to prepare and safeguard the natural substance, drug or device for delivery to the treating doctor's own patient.

---------------------------------- ‘Drug’, as defined in s.32-1901, Arizona Revised Statutes for Pharmacy35: 27. "Drug" means: (a) Articles recognized, or for which standards or specifications are prescribed, in the official compendium. (b) Articles intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in the human body or other. (c) Articles other than food intended to affect the structure or any function of the human body or other animals. (d) Articles intended for use as a component of any articles specified in subdivision (a), (b) or (c) of this paragraph but does not include devices or their components, parts or accessories.

-----------------------------------


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Arizona State Legislature – 32.1582 Notice from Naturopathic Physicians Board of Medical Examiners – Notice to Arizona

Pharmacists states36: “As of August 20, 2002, a licensed naturopathic physician will be able to legally prescribe any legend drug or controlled substance with the following exceptions: 1) Intravenous medications (except vitamins, chelation therapy, and drugs used in emergency resuscitation and stabilization, which will be allowed). 2) Controlled substances listed as schedule I or II (except morphine will be allowed) 3) cancer chemotherapeutics classified as legend drugs 4) antipsychotics” To support this broad prescribing authority, Arizona passed HR 2028 in 2002. This bill required, as of January 1, 2005, that all NDs complete a 60-hour series of pharmacy courses and pass an examination. After that date, only NDs who have completed the additional training and passed the test in pharmacotherapeutics are able to prescribe drugs and controlled substances. Southwest College in Tempe, Arizona has made this additional training part of their required curriculum for NDs.37

California Bureau of Naturopathic Medicine

Prescribing and administering

NDs require licensure under the Business and Professions Code, Division 2, Chapter 8.238 and Title 16 of the California Code of Regulations - Division 40. Bureau of Naturopathic Medicine39

In the Business and Professions Code, Division 2, Chapter 8.240

Article 1: 3613. The following definitions apply for the purposes of this chapter: (c) "Naturopathic medicine" means a distinct and comprehensive system of primary health care practiced by a naturopathic doctor for the diagnosis, treatment, and prevention of human health conditions, injuries, and disease. (e) "Naturopathy" means a noninvasive system of health practice that employs natural health modalities, substances, and education to promote health. (f) "Drug" means any substance defined as a drug by Section 11014 of the Health and Safety Code.

38 http://www.naturopathic.ca.gov/laws/index.htm39 http://www.naturopathic.ca.gov/laws/regs_4200.pdf

http://www.naturopathic.ca.gov/laws/index.htm

http://www.naturopathic.ca.gov/laws/regs_4200.pdf


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Article 4: 3640 (c) A naturopathic doctor may dispense, administer, order, and prescribe or perform the following: (1) Food, extracts of food, nutraceuticals, vitamins, amino acids, minerals, enzymes, botanicals and their extracts, botanical medicines, homeopathic medicines, all dietary supplements and nonprescription drugs as defined by the federal Food, Drug, and Cosmetic Act, consistent with the routes of administration identified in subdivision (d). (2) Hot or cold hydrotherapy; naturopathic physical medicine inclusive of the manual use of massage, stretching, resistance, or joint play examination but exclusive of small amplitude movement at or beyond the end range of normal joint motion; electromagnetic energy; colon hydrotherapy; and therapeutic exercise. (3) Devices, including, but not limited to, therapeutic devices, barrier contraception, and durable medical equipment. (4) Health education and health counseling. (5) Repair and care incidental to superficial lacerations and abrasions, except suturing. (6) Removal of foreign bodies located in the superficial tissues. 3640.5. Nothing in this chapter or any other provision of law shall be construed to prohibit a naturopathic doctor from furnishing or ordering drugs when all of the following apply: (a) The drugs are furnished or ordered by a naturopathic doctor in accordance with standardized procedures or protocols developed by the naturopathic doctor and his or her supervising physician and surgeon. (b) The naturopathic doctor is functioning pursuant to standardized procedure, as defined by subdivisions (a), (b), (d), (e), (h), and (i) of Section 2836.1 and paragraph (1) of subdivision (c) of Section 2836.1, or protocol. The standardized procedure or protocol shall be developed and approved by the supervising physician and surgeon, the naturopathic doctor, and, where applicable, the facility administrator or his or her designee. (c) The standardized procedure or protocol covering the furnishing of drugs shall specify which naturopathic doctors may furnish or order drugs, which drugs may be furnished or ordered under what circumstances, the extent of physician and surgeon supervision, the method of periodic review of the naturopathic doctor's competence, including peer review, and review of the

40 http://www.naturopathic.ca.gov/laws/index.shtml 41 http://www.naturopathic.ca.gov/laws/regs_4200.pdf42 http://www.naturopathic.ca.gov/laws/regs_4200.pdf

http://www.naturopathic.ca.gov/laws/index.shtml




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provisions of the standardized procedure. (d) The furnishing or ordering of drugs by a naturopathic doctor occurs under physician and surgeon supervision. Physician and surgeon supervision shall not be construed to require the physical presence of the physician, but does include all of the following: (1) Collaboration on the development of the standardized procedure. (2) Approval of the standardized procedure. (3) Availability by telephonic contact at the time of patient examination by the naturopathic doctor. (e) For purposes of this section, a physician and surgeon shall not supervise more than four naturopathic doctors at one time. (f) Drugs furnished or ordered by a naturopathic doctor may include Schedule III through Schedule V controlled substances under the California Uniform Controlled Substances Act (Division 10 (commencing with Section 11000) of the Health and Safety Code) and shall be further limited to those drugs agreed upon by the naturopathic doctor and physician and surgeon as specified in the standardized procedure. When Schedule III controlled substances, as defined in Section 11056 of the Health and Safety Code, are furnished or ordered by a naturopathic doctor, the controlled substances shall be furnished or ordered in accordance with a patient-specific protocol approved by the treating or supervising physician. A copy of the section of the naturopathic doctor's standardized procedure relating to controlled substances shall be provided upon request, to a licensed pharmacist who dispenses drugs, when there is uncertainty about the naturopathic doctor furnishing the order. (g) The bureau has certified that the naturopathic doctor has satisfactorily completed adequate coursework in pharmacology covering the drugs to be furnished or ordered under this section. The bureau shall establish the requirements for satisfactory completion of this subdivision. (h) Use of the term "furnishing" in this section, in health facilities defined in subdivisions (b), (c), (d), (e), and (i) of Section 1250 of the Health and Safety Code, shall include both of the following: (1) Ordering a drug in accordance with the standardized procedure. (2) Transmitting an order of a supervising physician and surgeon. (i) For purposes of this section, "drug order" or "order" means an order for medication which is dispensed to or for an ultimate user, issued by a naturopathic doctor as an individual practitioner, within the meaning of Section 1306.02 of Title 21 of the Code of Federal Regulations. (j) Notwithstanding any other provision of law, the following apply: (1) A drug order issued pursuant to this section shall be treated in the same manner as a


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prescription of the supervising physician. (2) All references to prescription in this code and the Health and Safety Code shall include drug orders issued by naturopathic doctors. (3) The signature of a naturopathic doctor on a drug order issued in accordance with this section shall be deemed to be the signature of a prescriber for purposes of this code and the Health and Safety Code. 3640.7. Notwithstanding the requirements of Section 3640.5 or any other provision of this chapter, a naturopathic doctor may independently prescribe epinephrine to treat anaphylaxis and natural and synthetic hormones. 3642. A naturopathic doctor may not perform any of the following functions: (a) Prescribe, dispense, or administer a controlled substance or device identified in Sections 801 to 971, inclusive, of Title 21 of the United States Code, except as authorized by this chapter. (b) Administer therapeutic ionizing radiation or radioactive substances. (c) Practice or claim to practice any other system or method of treatment beyond that authorized by this chapter, for which licensure is required, unless otherwise licensed to do so. (d) Administer general or spinal anesthesia. (e) Perform an abortion. (f) Perform any surgical procedure. (g) Perform acupuncture or traditional Chinese and Asian medicine, including Chinese herbal medicine, unless licensed as an acupuncturist as defined in subdivision (c) of Section 4927. Under Title 16, California Code of Regulations… Article 6. Practice of Naturopathic Medicine 4234. Naturopathic Medical Services Performable.41 (a) A licensee of the Bureau may order and perform the following functions:

(1) Those functions expressly specified in subdivisions (a) and (c) of Section 3640 of the Code. (2) The independent prescription and administration of epinephrine to treat anaphylaxis, as specified in Section 3640.7 of the Code. (3) The independent prescription of natural and synthetic hormones, as specified in Section 3640.7 of the Code.

(b) A licensee may order the studies and tests specified in subdivision (b) of Section 3640 of the Code and other A licensee may not interpret the results of the tests or studies so ordered unless the


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licensee holds an appropriate license. diagnostic tests provided that the licensee is clinically competent in this area. (c) A licensee may not perform the following functions:

(1) The functions specified in Section 3642 of the Code. (2) The practice of marriage and family therapy as defined in Section 4980.02 of the Code, unless appropriately licensed. (3) The practice of clinical social work and psychotherapy as defined in Section 4996.9 of the Code, unless appropriately licensed.

(d) A licensee may the utilize all of the routes of administration specified in subdivision (d) of Section 3640 of the Code except for the ocular and intravenous routes of administration. A licensee may only utilize the ocular and intravenous routes of administration if he or she in clinically competent in those areas. (e) For the purposes of this section, “clinically competent” means that one possesses and exercises the degree of learning, skill, care and experience ordinarily possessed and exercised by a member of the appropriate discipline in clinical practice. NOTE: Authority cited: Sections 3622 and 3640, Business and Professions Code. Reference: Sections 3640, 3640.5, 3640.7 and 3642, Business and Professions Code. 4236. Furnishing and Ordering of Drugs. 42

(a) In order to furnish or order drugs or dangerous devices pursuant to Section 3640.5 of the Code or prescribe drugs or dangerous devices pursuant to Section 3640.7 of the Code, a licensee shall first obtain a furnishing number from the Bureau by submitting written evidence to the Bureau of all the information required by Section 4212(a)(7). (b) The furnishing and ordering of drugs or dangerous devices pursuant to Section 3640.5 of the Code by a licensee is conditional upon all the following:

(1) Compliance with subdivisions (a), (b), (c), (d), and (f) of Section 3640.5 of the Code. (2) Registration with the United States Drug Enforcement Agency, where required. (3) The issuance of a furnishing number to the licensee by the Bureau.

(c) The prescribing of drugs or dangerous devices pursuant to Section 3640.7 by a licensee is conditional upon the issuance of a furnishing number to the licensee by the Bureau, and registration with the United States Drug Enforcement Agency where required.


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(d) A drug order or prescription for a dangerous drug or dangerous device issued by a naturopathic doctor shall comply with the requirements of Section 4040 of the Code. (e) Furnishing, ordering or prescribing a controlled substance pursuant to Sections 3640.5(f) or 3640.7 of the Code shall be furnished, ordered, or prescribed in compliance with the California Uniform Controlled Substances Act (Division 10 (commencing with Section 11000) of the Health and Safety Code). NOTE: Authority cited: Sections 3620, 3622 and 3640.5(g), Business and Professions Code. Reference: Sections 3640.5, 3640.7, and 4040, Business and Professions Code; Section 11164, Health and Safety Code.

Connecticut Connecticut State Board of Naturopathic Examiners

No direct authority prescribe or administer

General Statutes of Connecticut, Title 20, Professional and Occupational Licensing, Certification, Title Protection and Registration. Examining Boards, Chapter 373.43

In the Statutes Sec. 20-34. Practice defined. (a) The practice of natureopathy means the science, art and practice of healing by natural methods as recognized by the Council of Natureopathic Medical Education and approved by the State Board of Natureopathic Examiners, with the consent of the commissioner, and shall include (1) counseling and (2) the practice of the mechanical and material sciences of healing as follows: The mechanical sciences such as mechanotherapy, articular manipulation, corrective and orthopedic gymnastics, physiotherapy, hydrotherapy, electrotherapy and phototherapy; and the material sciences such as nutrition, dietetics, phytotherapy, treatment by natural substances and external applications. (b) For purposes of subsection (a) of this section, "natural substances" means substances which are not narcotic substances, as defined in subdivision (30) of section 21a-240, do not require the written or oral prescription of a licensed practitioner to be dispensed and are only administered orally.

District of Columbia DC Board of Medicine

No authority to prescribe or administer

District of Columbia Municipal Regulations for Naturopathic Medicine

In the Statutes: Chapter 52 Naturopathic Medicine 5210.2 An individual licensed to practice naturopathic medicine may:

a) Administer or provide for preventive and therapeutic purposes natural medicines by their appropriate route of administration the following:

(1) Natural remedies; (2) Topical medicine;

43 Connecticut Licensing Info Center, Physician Licensure - Naturopathic – Initial, http://www.ct-clic.com/TradeLicenses/appView.asp?AppView=Physician+Licensure+-+Naturopathic-Initial___Authorize+an+individual+to+practice+naturopathy.+%0D%0A___1734___821&appID=1734

http://search.cga.state.ct.us/surs/Title20.htm







http://hpla.doh.dc.gov/hpla/cwp/view,a,1195,q,488575.asp

http://hpla.doh.dc.gov/hpla/cwp/view,a,1195,q,488575.asp

http://www.ct-clic.com/TradeLicenses/appView.asp?AppView=Physician+Licensure+-+Naturopathic-Initial___%3Cfont+class%3Dtext%3EAuthorize+an+individual+to+practice+naturopathy.%3C/font%3E+%0D%0A___1734___821&appID=1734

http://www.ct-clic.com/TradeLicenses/appView.asp?AppView=Physician+Licensure+-+Naturopathic-Initial___%3Cfont+class%3Dtext%3EAuthorize+an+individual+to+practice+naturopathy.%3C/font%3E+%0D%0A___1734___821&appID=1734


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District Of Columbia Municipal Naturopathy Regulation

(3) Counseling; (4) Hypnotherapy; (5) Dietary therapy; (6) Naturopathic physical medicine; (7) Therapeutic devices; and (8) Barrier devices for contraception.

(b) Review and interpret the results of diagnostic procedures commonly used by physicians in general practice, including: (1) Physical and orificial examinations; (2) Electrocardiograms; (3) Diagnostic imaging techniques; (4) Phlebotomy; (5) Clinical laboratory test and examinations; and (6) Physiological function tests.

5210.4 An individual licensed to practice naturopathic medicine under this Act shall not: (a) Prescribe, dispense, or administer any controlled substances, except those natural medicine authorized by this Act; (b) Perform surgical procedures, except for minor office procedures, as defined by rule; (c) Use for therapeutic purposes, any device regulated by the United States Food and Drug Administration (FDA) that has not been approved by the FDA; (d) Participate in naturopathic childbirth, unless the naturopathic physician:

(1) Passes a specialty examination in obstetrics or natural childbirth approved by the Advisory Committee on Naturopathic Medicine, the Board of Medicine, or the Mayor, such as the American College of Nurse Midwives Written Examination or an equivalent national examination; (2) Has a minimum of 100 hours of course work, internship, or preceptorship in obstetrics of natural childbirth approved by the Advisory Committee on Naturopathic Medicine; (3) Files with the Department of Health and maintains a written collaboration agreement with a licensed obstetrician who is qualified to perform obstetrical surgery; and (4) Has assisted in a minimum of fifty (50) supervised births, including prenatal and postnatal care, under the direct supervision of a licensed naturopathic, medical, or osteopathic physician with training in obstetrics or natural childbirth, at least twenty-five (25) of which document the naturopathic physician as the primary birth attendant.

Chapter 50, Naturopathy 5003.4 It shall be unlawful for a naturopath practicing in the District of Columbia to:

(a) Falsely lead any person to believe he or she practices medicine as defined in the Act.


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(b) Use x-rays, perform surgical procedures, inject any substance into another person by needle, or perform any invasive procedure on another person;

(c) Deliver infants;

(d) Prescribe for or provide to another person any drugs, substance or device regulated by the laws of the District or Federal governments or available by prescription only; or

(e) File birth or death certificates or sign claims or authorization for payment of workers’ compensation benefits, Medicare or Medicaid benefits, or benefits provided for health care through other publicly assisted programs.

5099.1 “Naturally occurring substances” means food, natural vitamins and minerals, herbs and herbal preparations, roots, barks, homeopathic preparations, plant substances and natural medicines of animal, mineral or botanical origin which do not require a prescription unless from a homeopathic pharmacy.

“Counseling individuals and treatment through the use of naturally occurring substances” includes, but is not limited to, giving advice, ordering or prescribing naturally occurring substances, and the use of physical modalities, and other treatments, commonly provided by naturopaths and not otherwise prohibited under the Act.

“Drug, substance, or device” means a prescription or pharmaceutical drug, substance or a device but shall not include “naturally occurring substances.”

Hawaii Board of Examiners in Naturopathy

Prescribing and administer natural medicine

NDs are regulated under Hawaii Revised Statute Chapter 455.44

In the Statutes…. 455-1 Definitions45

"Natural medicine" encompasses substances of botanical, mineral, and animal origin, homeopathic preparations thereof, and substances whose natural state has been improved by any process that does not substantially alter the molecular structure found in nature, including vitamins, minerals, and amino acids; excluding prescription drugs, with the following exceptions: vitamins, minerals, amino acids, and fatty acids. "Naturopathy" means the practice of:

44 http://www.capitol.hawaii.gov/hrscurrent/Vol10_Ch0436-0474/HRS0455/HRS_0455-0001.htm45 http://www.capitol.hawaii.gov/hrscurrent/Vol10_Ch0436-0474/HRS0455/HRS_0455-0001.htm

http://www.capitol.hawaii.gov/hrscurrent/Vol10_Ch0436-0474/HRS0455/HRS_0455-0001.htm

http://www.capitol.hawaii.gov/hrscurrent/Vol10_Ch0436-0474/HRS0455/HRS_0455-0001.htm


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(1) Natural medicine, natural therapeutics, and natural procedures, for the purpose of removing toxic conditions from the body and improving the quality, quantity, harmony, balance, and flow of the vital fluids, vital tissues, and vital energy; and

(2) Diagnosing, treating, and caring for patients using a system of practice that bases its treatment of physiological functions and abnormal conditions on natural laws governing the human body: utilizing physiological, psychological, and mechanical methods, such as air, water, light, sunshine, heat and cold, earth, phytotherapy, physiotherapy, mechano-therapy, naturopathic corrections and manipulation, and natural methods or modalities, together with natural or homeopathic medicines, natural foods, and herbs, and nature's remedies of the type taught in education and training at naturopathic medical colleges. The practice of naturopathy excludes surgery, application of x-rays, and prescribing, dispensing, or using prescription drugs except as provided for in the definition of natural medicine. [L 1925, c 77, pt of §1; RL 1935, §1300; RL 1945, §2651; RL 1955, §66-1; HRS §455-1; am L 1986, c 76, §5; am L 1987, c 281, §2(1); am L 1994, c 71, §1]

Idaho Idaho Board of Naturopathic Medical Examiners

Prescribe and administer

Although NDs have the authority to prescribe and administer under Idaho Statutes, Title 54 Professions, Vocations, and Businesses, Chapter 51 Naturopathic Physicians Licensing Act, 46 the formulary mentioned in the legislation has yet to be created.

In the Statutes Scope of Practice 47

(1) Diagnostic procedures. A naturopathic physician may use physical and laboratory examinations consistent with naturopathic medical education and training for diagnostic purposes. A naturopathic physician may order and perform diagnostic and imaging tests consistent with naturopathic medical education and training. All diagnostic and imaging tests not consistent with naturopathic medical education and training, must be referred for performance and interpretation by an appropriately licensed health care professional. (2) Naturopathic physicians are authorized to dispense, administer and prescribe prescription drugs and medical devices determined by the naturopathic medical formulary council, and authorized by the board. (3) A naturopathic physician may perform minor office procedures pursuant to privileges authorized by the board. (4) A naturopathic physician may perform those therapies as trained and educated and authorized by the board.

46 http://www3.state.id.us/idstat/TOC/54051KTOC.html 47 Naturopathic Physicians Licensing Act Chapter 51, s. 54-5104 of Title 54 – Professions, Vocations and Businesses

http://www3.state.id.us/idstat/TOC/54051KTOC.html


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DEFINITIONS48. As used in this chapter, the following terms have the meanings as stated: (4) "Naturopathic medical formulary" means the list of prescription medicines which naturopathic physicians use in the practice of their profession, as determined by the formulary council and reviewed by the board. (5) "Naturopathic medical formulary council" means that council comprised of members appointed pursuant to this chapter to determine and authorize the formulary list. (6) "Naturopathic medicine" means a distinct and comprehensive system of primary health care practiced by naturopathic physicians. For the purpose of this chapter, naturopathic medicine does not include natural health care services as defined herein, however, nothing contained herein is intended to prohibit a naturopathic physician from providing natural health care services. (8) "Natural health care services" means the broad domain of health care services and procedures, including diagnosis and treatment, where treatment or advice regarding the human body and its functions is administered by a person who: (a) Does not use legend drugs or prescription drugs in such practice; (b) Uses only natural elements including, without limitation, air, heat, water and light; (c) Only uses class I or class II nonprescription, approved medical devices as defined in section 513 of the federal food, drug and cosmetic act; (d) Only uses vitamins, minerals, herbs, natural food products and their extracts, nutritional supplements and homeopathic preparations and remedies not otherwise prohibited by law; and who (e) Does not perform surgery. PROHIBITIONS49. A naturopathic physician shall not: (1) Prescribe, dispense or administer any controlled substance or device identified under the controlled substance act, chapter 27, title 37, Idaho Code, or identified in the federal controlled substance act, 21 U.S.C. sections 801 through 971 (1988), as amended, except as authorized by this chapter; (2) Perform surgical procedures except those minor office procedures authorized by this chapter; (3) Practice or claim to practice as a medical doctor, osteopath, dentist, podiatrist, optometrist, psychologist, advanced practice professional nurse, physician assistant, chiropractor, physical

48 http://www3.state.id.us/cgi-bin/newidst?sctid=540510002.K49 http://www3.state.id.us/cgi-bin/newidst?sctid=540510005.K50 http://www.naturopathic.ca.gov/formspubs/formulary_report.pdf

http://www3.state.id.us/cgi-bin/newidst?sctid=540510002.K

http://www3.state.id.us/cgi-bin/newidst?sctid=540510005.K



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therapist, acupuncturist, or any other health care professional not authorized in this chapter unless licensed by the state of Idaho to do so; (4) Use general or spinal anesthetics; (5) Administer ionizing radioactive substances for therapeutic purposes; (6) Perform surgical procedures using a laser device; (7) Induce or perform an abortion; (8) Perform surgical procedures involving the eye, ear, tendons, nerves, veins or arteries extending beyond superficial tissue; (9) Treat any lesion suspicious of malignancy or requiring surgical removal. Lesions suspicious of malignancy or requiring surgical removal shall be referred to an appropriately licensed health care professional. Nothing in this chapter shall prohibit treatment of a person with suspicious or malignant lesions in conjunction with a physician licensed pursuant to chapter 18, title 54, Idaho Code. (10) Perform chiropractic adjustments as defined in section 54-704, Idaho Code. (11) Perform physical therapy as defined in section 54-2203, Idaho Code.

--------------------------------------- From a 2007 report50 submitted to the California legislature by the Bureau of Naturopathic Medicine, California Department of Consumer Affairs: Idaho passed a bill in 2005 authorizing licensure of NDs. The bill creates a formulary council to establish a formulary for use by NDs that is consistent with the training and education of NDs. The formulary will be reviewed on an annual basis. To date, the formulary has not been completed.

Kansas Kansas State Board of Healing Arts

Administration with requirements.

NDs are regulated under Kansas Statute Chapter 65.—Public Health Article 72 ‘Naturopathic Doctors’. 51

In the Statutes….52

65-7202. Definitions (2) "Naturopathic medicine," or "naturopathy" means a system of health care practiced by naturopathic doctors for the prevention, diagnosis and treatment of human health conditions, injuries and diseases, that uses education, natural medicines and therapies to support and stimulate the individual's intrinsic self-healing processes, and includes prescribing, recommending or administering: (A) Food, food extracts, vitamins, minerals, enzymes, whole gland thyroid, botanicals, homeopathic preparations, nonprescription drugs, plant substances that are not designated as prescription drugs or controlled substances, topical drugs as defined in

51 http://www.kslegislature.org/legsrv-statutes/getStatute.do?number=2706652 http://www.kslegislature.org/legsrv-statutes/getStatute.do?number=2706753 http://www.naturopathic.ca.gov/formspubs/formulary_report.pdf

http://www.kslegislature.org/legsrv-statutes/getStatute.do?number=27066

http://www.kslegislature.org/legsrv-statutes/getStatute.do?number=27067



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subsection (a)(9) of this section, and amendments thereto; (B) health care counseling, nutritional counseling and dietary therapy, naturopathic physical applications, barrier contraceptive devices; (C) substances on the naturopathic formulary which are authorized for intramuscular or intravenous administration pursuant to a written protocol entered into with a physician who has entered into a written protocol with a naturopathic doctor registered under this act; (D) noninvasive physical examinations, venipuncture to obtain blood for clinical laboratory tests and oroficial examinations, excluding endoscopies; (E) minor office procedures; and (F) naturopathic acupuncture. A naturopathic doctor may not perform surgery, obstetrics, administer ionizing radiation, or prescribe, dispense or administer any controlled substances as defined in K.S.A. 65-4101, and amendments thereto, or any prescription-only drugs except those listed on the naturopathic formulary adopted by the board pursuant to this act. (9) “Topical drugs” means topical analgesics, antiseptics, scabicides, antifungals and

antibacterials but does not include prescription only drugs.

65-7212. Board of healing arts to adopt naturopathic formulary; naturopathic formulary advisory committee. (a) The board shall adopt a naturopathic formulary which lists the drugs and substances which are approved for intramuscular or intravenous administration by a naturopathic doctor pursuant to the order of a physician. The board shall appoint a naturopathic formulary advisory committee which shall advise the board and make recommendations on the list of substances which may be included in the naturopathic formulary. The naturopathic formulary advisory committee shall consist of a licensed pharmacist, a person knowledgeable in medicinal plant chemistry, two persons licensed to practice medicine and surgery, and two naturopathic doctors registered under this act. (b) The provisions of this section shall take effect on and after January 1, 2003.

-----------------------------------------------------

From a 2007 report53 submitted to the California legislature by the Bureau of Naturopathic Medicine, California Department of Consumer Affairs: Kansas passed an ND licensing law in 2003. It authorizes an intravenous and intramuscular formulary which must be under the supervision of a physician. Kansas is the only state, other than California, which requires continuous MD supervision for prescribing.


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Maine State of Maine’s Complementary Health Care Providers Board

Prescribing and administering

NDs are regulated under Maine Revised Statute, Title 32: Professions and Occupations, Chapter 113-B: Complementary Health Care Providers Heading54

Board of Complementary Health Care Providers Rules

In the Statute55

§12522. Scope of practice 1. Medicines and therapies. A naturopathic doctor may use and order for preventative and

therapeutic purposes the following natural medicines and therapies: food, food extracts, vitamins, minerals, enzymes, digestive aids, whole gland thyroid and other natural hormones, plant substances, all homeopathic preparations, immunizations, counseling, hypnotherapy, biofeedback, dietary therapy, naturopathic manipulative therapy, naturopathic physical medicine, therapeutic devices, barrier devices for contraception and office procedures. Naturopathic doctors may also prescribe medications, including natural antibiotics and topical medicines, within the limitations set forth in subsection 4. This subsection may not be construed to prevent an individual other than a naturopathic doctor from using, ordering or recommending any of the above listed items as long as the individual is not prohibited from doing so by any other federal or state statute or regulation.

2. Diagnostic procedures. A naturopathic doctor may use physical examinations for diagnostic purposes including phlebotomy, clinical laboratory tests, speculum examinations and physiological function tests, excluding all endoscopies and physiological function tests requiring infusion, injection, inhalation or ingestion of medications to perform tests. A naturopathic doctor may order ultrasound, x-ray and electrocardiogram tests but must refer to an appropriate licensed health care professional for conducting and interpreting the tests.

3. Other devices and procedures. A naturopathic doctor may prescribe therapeutic devices or use noninvasive diagnostic procedures commonly used by allopathic or osteopathic physicians in general practice.

4. Prescriptive authority. Naturopathic doctors have a limited scope of prescriptive authority.

A. A naturopathic doctor may prescribe nonprescription medications without limitation. B. A naturopathic doctor may only prescribe noncontrolled legend drugs from the following

categories: homeopathic remedies, vitamins and minerals, hormones, local anesthesia and immunizations that are designated by rule by a subcommittee of the board consisting of the naturopathic members, the pharmacist member and the allopathic or osteopathic physician member, as consistent with a naturopathic doctor's education and training. A naturopathic doctor may not prescribe psychotropic medications.

C. Prior to independently prescribing noncontrolled legend drugs, a naturopathic doctor shall

54 http://www.mainelegislature.org/legis/statutes/32/title32sec12501.html55 http://www.mainelegislature.org/legis/statutes/32/title32sec12501.html56 http://www.naturopathic.ca.gov/formspubs/formulary_report.pdf

http://www.maine.gov/sos/cec/rules/02/chaps02.htm#502




http://www.mainelegislature.org/legis/statutes/32/title32sec12501.html

http://www.mainelegislature.org/legis/statutes/32/title32sec12501.html



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establish and complete a 12-month collaborative relationship with a licensed allopathic or osteopathic physician to review the naturopathic doctor's prescribing practices. The board shall further define the terms of the collaborative relationship by rule.

5. Prohibition. A naturopathic doctor may not: A. Prescribe, dispense or administer any substance or device identified in Schedule I, II, III,

IV or V as described in the federal Controlled Substance Act, 21 United States Code, Sections 801 to 971 (1988), or any controlled substances or devices;

B. Perform surgical procedures except those office procedures authorized by this chapter; C. Practice emergency medicine except when a good Samaritan rendering gratuitous services

in the case of emergency and except for the care of minor injuries; or D. Practice or claim to practice medicine and surgery, osteopathy, dentistry, podiatry,

optometry, chiropractic, physical therapy or any other system or method of treatment not authorized in this chapter. In the Rules, Chapter 5: Standards for Continuing Professional Education for Acupuncturists and Naturopathic Doctors 3. Naturopathic doctor standards for continuing education. A. Licensed naturopathic doctors shall complete 37 hours of continuing education annually. Naturopathic doctors who hold a specialty certification in naturopathic acupuncture must complete an additional 15 hours of continuing education annually, specific to that specialty. The 37 hours shall consist of the following: 1. At least 7 hours shall be in pharmacology; 2. No more than 15 hours may be in naturopathic and/or medical journals or audio- or videotaped presentations, slides, programmed instruction or computer-assisted instruction and/or preceptorships; 3. No more than 10 hours may be in any single topic; and 4. The additional 15 hours of continuing education required for specialty certification in acupuncture shall meet the standards of continuing education for acupuncturists as described in chapter 5, section 2 (B) of these rules. In the Rules, Chapter 6: Standards relating to prescriptive Authorities and Collaborative Relationship 1. Authority to use, prescribe, dispense and order. A naturopathic doctor may prescribe

nonprescription medication without limitation. Licensed naturopathic doctors may use, prescribe, dispense, and order certain medicines of mineral, animal, and botanical origin

http://www.maine.gov/sos/cec/rules/02/502/502c005.doc


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including the following: A. Nonlegend medicines derived from animal organs, tissues, and oils, minerals,

and plants administered orally and topically; B. Noncontrolled legend topical ointments, creams and lotions containing antiseptics; C. Noncontrolled legend topical, local anesthetics applied to superficial structures

for use during minor office procedures as appropriate; D. Noncontrolled legend vitamins, minerals, trace minerals, and whole glandulars

including whole gland thyroid; E. Contraceptive devices except intrauterine devices; F. All homeopathic preparations; G. Immunizing agents approved by the Bureau of Biologics, United States Food and

Drug Administration and listed in the current Recommendations of the United States Public Health Services Immunizations Practices Advisory Committee or the Report of the Committee of Infectious Diseases published by the American Academy of Pediatrics;

H. IM injections of vitamins, minerals and medications administered consistent with their scope of practice as a naturopathic doctor and training; and

2. Terms of collaborative relationship. A. It is the responsibility of the naturopathic doctor to enter into a professional

relationship with a licensed allopathic or osteopathic physician for the historical review of the prescriptive practice of the naturopathic doctor. The naturopathic doctor must meet with the M. D. or D.O. on a quarterly basis for a period of one (1) year to review the naturopathic doctor’s prescriptive practices.

B. The naturopathic doctor will keep a duplicate of all prescriptions written for the duration of the one (1) year collaborative relationship. These prescriptions will be reviewed on a quarterly basis with the collaborating physician.

C. Approximately forty-five (45) days prior to the licensure expiration date, the board will send to naturopathic doctors in their first year of practice a reporting form for the collaborative relationship. Each naturopathic doctor will submit with the licensure renewal form, the form signed by the collaborating doctor stating that the conditions of the collaborative relationship have been met.

3. Maine Naturopathic Formulary Based on statute Title 32 Chapter 113-B and rulemaking:


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A. Controlled substances, as specified in the Controlled Substances Act, may not be prescribed.

B. Psychotropic medications may not be prescribed. C. IV medications, except rehydration, may not be administered. D. Medications which do not fall under the following categories of medications are

listed at the end of this document. E. Categories of medications which may be prescribed: 1. Amino Acids: (IV use of amino acids excluded.) All amino acids and

amino acid combinations to include but not limited to: Acetylcysteine Glycine Lysine Taurine Alanine Histidine Methionine Threonine Arginine Hydroxyproline N-acetylcysteine Tryptophan Aspartic acid Isoleucine Phenylalanine Tyrosine Carnitine Leucine Proline Valine Glutamic acid Levocarnitine Serine 2. Analgesics: Topical analgesics.

------------------------------------ From a 2007 report56 submitted to the California legislature by the Bureau of Naturopathic Medicine, California Department of Consumer Affairs: Maine NDs are allowed to independently prescribe noncontrolled legend drugs after completing a 12-month collaborative relationship with a licensed allopathic or osteopathic physician to review the NDs prescribing practices.


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Minnesota Board of Medical Practice

No authority to prescribe or administer legend drugs.

NDs in Minnesota have recently become regulated by the Minnesota Statute, chapter 147E. Registered Naturopathic Doctor57

In the Statute…. SCOPE OF PRACTICE58

147E.05 Subdivision 1.Practice parameters. (a) The practice of naturopathic medicine includes, but is not limited to, the following services: (1) ordering, administering, prescribing, or dispensing for preventive and therapeutic purposes: food, extracts of food, nutraceuticals, vitamins, minerals, amino acids, enzymes, botanicals and their extracts, botanical medicines, herbal remedies, homeopathic medicines, dietary supplements and nonprescription drugs as defined by the federal Food, Drug, and Cosmetic Act, glandulars, protomorphogens, lifestyle counseling, hypnotherapy, biofeedback, dietary therapy, electrotherapy, galvanic therapy, oxygen, therapeutic devices, barrier devices for contraception, and minor office procedures, including obtaining specimens to assess and treat disease; (2) performing or ordering physical examinations and physiological function tests; (3) ordering clinical laboratory tests and performing waived tests as defined by the United States Food and Drug Administration Clinical Laboratory Improvement Amendments of 1988 (CLIA); (4) referring a patient for diagnostic imaging including x-ray, CT scan, MRI, ultrasound, mammogram, and bone densitometry to an appropriately licensed health care professional to conduct the test and interpret the results; (5) prescribing nonprescription medications and therapeutic devices or ordering noninvasive diagnostic procedures commonly used by physicians in general practice; and (6) prescribing or performing naturopathic physical medicine. (b) A registered naturopathic doctor may admit patients to a hospital if the naturopathic doctor meets the hospital's governing body requirements regarding credentialing and privileging process. Subd. 2.Prohibitions on practice. (a) The practice of naturopathic medicine does not include: (1) administering therapeutic ionizing radiation or radioactive substances; (2) administering general or spinal anesthesia; (3) prescribing, dispensing, or administering legend drugs or controlled substances

57 https://www.revisor.leg.state.mn.us/statutes/?id=147E&view=chapter&year=2008&keyword_type=all&keyword=naturopathic#stat.147E.0158 https://www.revisor.leg.state.mn.us/statutes/?id=147E&view=chapter&year=2008&keyword_type=all&keyword=naturopathic#stat.147E.01

https://www.revisor.leg.state.mn.us/statutes/?id=147E&view=chapter&year=2008&keyword_type=all&keyword=naturopathic#stat.147E.01

https://www.revisor.leg.state.mn.us/statutes/?id=147E&view=chapter&year=2008&keyword_type=all&keyword=naturopathic#stat.147E.01


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including chemotherapeutic substances; or (4) performing or inducing abortions. (b) A naturopathic doctor registered under this chapter shall not perform surgical procedures using a laser device or perform surgical procedures beyond superficial tissue. (c) A naturopathic doctor shall not practice or claim to practice as a medical doctor, surgeon, osteopath, dentist, podiatrist, optometrist, psychologist, advanced practice professional nurse, physician assistant, chiropractor, physical therapist, acupuncturist, dietician, nutritionist, or any other health care professional, unless the naturopathic physician also holds the appropriate license or registration for the health care practice profession.

Montana Montana Alternative Health Care Board

Prescribe and administer, limited to a formulary

NDs are regulated under Montana Annotated Code, Title 37, Professions and Occupations, Ch. 26. Naturopathic Physicians59

In the Code… Scope of Practice60

37-26-301. Practice of naturopathic health care -- alternative health care formulary committee (1) Naturopathic physicians may practice naturopathic medicine as a limited practice of the healing arts as exempted in 37-3-103(1)(m), with the following restrictions. A naturopathic physician may not: (a) prescribe, dispense, or administer any legend drug, as defined in 50-31-301, [see statute below] except for whole gland thyroid; homeopathic preparations; the natural therapeutic substances, drugs, and therapies described in subsection (2); and oxytocin (pitocin), provided that the naturopathic physician may administer but may not prescribe or dispense oxytocin (pitocin); (b) administer ionizing radioactive substances for therapeutic purposes; (c) perform surgical procedures except those minor surgery procedures authorized by this chapter; or (d) claim to practice any licensed health care profession or system of treatment other than naturopathic medicine unless holding a separate license in that profession. (2) Naturopathic physicians may prescribe and administer for preventive and therapeutic purposes the following natural therapeutic substances, drugs, and therapies, as well as drugs on the natural substance formulary list provided for in subsection (3):

The Board has a Naturopathic Physician Natural Substance Formulary List.63 This list states Naturpathic Physicians can prescribe and administer the following: (2) Naturopathic physicians may prescribe and administer all amino acids and amino acid combinations.

59 http://data.opi.mt.gov/bills/mca_toc/37_26.htm60 http://data.opi.mt.gov/bills/mca_toc/37_26_3.htm61 http://data.opi.mt.gov/bills/mca/50/31/50-31-301.htm 62 http://www.naturopathic.ca.gov/formspubs/formulary_report.pdf63http://mt.gov/dli/bsd/license/bsd_boards/ahc_board/pdf/formulary.pdf

http://data.opi.mt.gov/bills/mca/37/3/37-3-103.htm


http://data.opi.mt.gov/bills/mca_toc/37_26.htm

http://data.opi.mt.gov/bills/mca_toc/37_26_3.htm



http://mt.gov/dli/bsd/license/bsd_boards/ahc_board/pdf/formulary.pdf


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(a) food, food extracts, vitamins, minerals, enzymes, whole gland thyroid, botanical medicines, homeopathic preparations, and oxytocin (pitocin); (b) topical drugs, health care counseling, nutritional counseling and dietary therapy, naturopathic physical applications, therapeutic devices, and nonprescription drugs; and (c) barrier devices for contraception, naturopathic childbirth attendance, and minor surgery. (3) A five-member alternative health care formulary committee appointed by the board shall establish a natural substance formulary list. The committee consists of a licensed pharmacist plus four members of the board, two of whom must be licensed naturopathic physicians, one who must be a licensed medical doctor, and one who must be a public member. The list may not go beyond the scope of substances covered by approved naturopathic college curricula or continuing education and must be reviewed annually by the committee. Changes to the list that are recommended by the committee and accepted by the board must be published as administrative rules. (4) Naturopathic physicians may perform or order for diagnostic purposes a physical or orificial examination, ultrasound, phlebotomy, clinical laboratory test or examination, physiological function test, and any other noninvasive diagnostic procedure commonly used by physicians in general practice and as authorized by 37-26-201(2). (5) Except as provided by this subsection, it is unlawful for a naturopath to engage, directly or indirectly, in the dispensing of any drugs that a naturopath is authorized to prescribe by subsection (2). If the place where a naturopath maintains an office for the practice of naturopathy is more than 10 miles from a place of business that sells and dispenses the drugs a naturopath may prescribe under subsection (2), then, to the extent the drugs are not available within 10 miles of the naturopath's office, the naturopath may sell the drugs that are unavailable. 37-26-103. Definitions (5) (a) "Minor surgery" means the use of: (i) operative, electrical, or other methods for the surgical repair and care incidental to superficial lacerations and abrasions, superficial lesions, and the removal of foreign bodies located in the superficial tissues; and (ii) antiseptics and local anesthetics in connection with the methods. (b) Minor surgery does not include general or spinal anesthetics, major surgery, surgery of the body cavities, or specialized surgeries, such as plastic surgery, surgery involving the eyes, or surgery involving tendons, ligaments, nerves, or blood vessels.

(3) Naturopathic physicians may prescribe and administer antimicrobials. (4) Naturopathic physicians may prescribe and administer barrier contraceptives. (5) Naturopathic physicians may prescribe and administer all botanical extracts and their derivatives -- prescription and nonprescription substances -- as exemplified in traditional botanical and herbal pharmacopeia. (6) Naturopathic physicians may prescribe and administer electrolytes and fluid replacement. (7) Naturopathic physicians may prescribe and administer expectorants and mucolytics.



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(7) "Naturopathic medicine", "naturopathic health care", or "naturopathy" means a system of primary health care practiced by naturopathic physicians for the prevention, diagnosis, and treatment of human health conditions, injury, and disease. Its purpose is to promote or restore health by the support and stimulation of the individual's inherent self-healing processes. This is accomplished through education of the patient by a naturopathic physician and through the use of natural therapies and therapeutic substances. In the Montana Annotated Code, Title 50. HEALTH AND SAFETY, Chapter 31: MONTANA FOOD, DRUG, AND COSMETIC ACT 50-31-301. Definitions (5) "Legend drug" means any drug defined by section 503(b) of the federal act (21 U.S.C. 353(b)), as amended on January 15, 1980, under which its label is required to bear the statement: "Caution: Federal law prohibits dispensing without prescription."61

-----------------------------------------

From a 2007 report62 submitted to the California legislature by the Bureau of Naturopathic Medicine, California Department of Consumer Affairs: Montana law requires a five-member formulary committee to establish a natural substance formulary list and review the list on an annual basis. Among other items, the approved list of natural substances contains antibiotics and hormones.

(8) Naturopathic physicians may prescribe and administer enzyme, digestive and proteolytic preparations. (9) Naturopathic physicians may prescribe and administer homeopathic preparations - all prescription and nonprescription remedies. (10) Naturopathic physicians may prescribe and administer hormones. (11) Naturopathic physicians may prescribe and administer liver preparations. 12) Naturopathic physicians may prescribe and administer all prescription and nonprescription minerals, trace metals and their derivatives.


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(13) Naturopathic physicians may prescribe and dispense a number of miscellaneous drugs. (14) Naturopathic physicians may prescribe and administer vitamins, including all prescription and nonprescription vitamin preparations and their derivatives. (15) Naturopathic physicians may prescribe and administer childbirth preparations. (16) Naturopathic physicians may prescribe and administer topical medicines.

New Hampshire Naturopathic

No direct authority to prescribe or administer legend or controlled drugs.

NDs are regulated under Title XXX, Occupations and Professions,

Scope of Practice IX. "Naturopathic medicine'' means a system of primary health care practiced by doctors of naturopathic medicine for the prevention, diagnosis, and treatment of human health conditions,

The formulary67 lists low risk natural medications like barrier


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Board of Examiners

Chapter 328-E, Naturopathic Health Care Practice

injuries, and diseases that uses education, natural medicines and therapies to support and stimulate the individual's intrinsic self-healing processes. 64

I. Doctors of naturopathic medicine shall be authorized to use for preventive and therapeutic purposes the following natural medicines and therapies: food, food extracts, vitamins, minerals, enzymes, digestive aids, whole gland thyroid, plant substances, all homeopathic preparations, topical medicines, counseling, hypnotherapy, biofeedback, dietary therapy, naturopathic physical medicine, therapeutic devices, and barrier devices for contraception. II. Doctors of naturopathic medicine may use for diagnostic purposes physical and orifical examinations, X-rays, electrocardiograms, ultrasound, phlebotomy, clinical laboratory tests and examinations, and physiological function tests. III. Doctors of naturopathic medicine may prescribe nonprescription medications and therapeutic devices or use noninvasive diagnostic procedures commonly used by medical practitioners in general practice. IV. Doctors of naturopathic medicine shall not: (a) Prescribe, dispense, or administer any legend or controlled substances as defined in RSA 318 and 318-B, except those natural medicines as authorized by this chapter. (b) Perform surgical procedures. (c) Practice emergency medicine, except as a good samaritan rendering gratuitous services in the case of emergency and except for the care of minor injuries. (d) Practice or claim to practice medicine and surgery, osteopathy, dentistry, podiatry, optometry, chiropractic, physical therapy, or any other system or method of treatment not authorized in this chapter. V. Doctors of naturopathic medicine with specialty certification in naturopathic childbirth pursuant to RSA 328-E:12 shall be authorized to use oxytocin and pitocin.65

Council on Doctors of Naturopathic Medicine Formulary; Members; Duties66

III. The council established under paragraph I of this section shall determine the substances to be included in the formulary that may be prescribed by a doctor of naturopathic medicine acting under

contraceptives, electrolytes and aminos.

64 http://www.gencourt.state.nh.us/rsa/html/XXX/328-E/328-E-2.htm65 http://www.gencourt.state.nh.us/rsa/html/XXX/328-E/328-E-4.htm66 http://www.gencourt.state.nh.us/rsa/html/XXX/328-E/328-E-16.htm67 http://www.nh.gov/pharmacy/naturo-form.pdf

http://www.gencourt.state.nh.us/rsa/html/XXX/328-E/328-E-2.htm



http://www.nh.gov/pharmacy/naturo-form.pdf


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this chapter. The council shall review the formulary periodically. Immediately upon adoption or revision of the formulary, the council shall transmit the approved formulary to the board which shall adopt the formulary by rule. When determined to be appropriate to the scope of practice of doctors of naturopathic medicine the council on doctors of naturopathic medicine formulary may also consider synthetically-produced substances and their salts having an identical or substantially identical molecular structure to a plant or animal substance as found in nature to be plant or animal substances.

Oregon Oregon Board of Naturopathic Examiners

Prescribe, use and administer within a formulary

NDs are regulated under Title 15, ch. 685 of the Oregon Revised Statutes68 and a Naturopathic Formulary Compendium (see rightmost column for citation and description). Oregon Administrative Rules, Chapter 850

Scope of Practice (5) “Naturopathic medicine” means the discipline that includes physiotherapy, natural healing processes and minor surgery and has as its objective the maintaining of the body in, or of restoring it to, a state of normal health.69

(3) “Drugs” means all medicines and preparations and all substances, except nonpoisonous plant or animal substances in therapeutic dosages, food and water, substances listed on the formulary established under ORS 685.145 (3), over-the-counter substances, nonprescriptive and non Drug Enforcement Agency regulated homeopathic substances and nutritional supplements, used or intended to be used for the diagnosis, cure, treatment, mitigation or prevention of diseases or abnormalities of humans, which are recognized in the latest editions of the official United States Pharmacopoeia, official Homeopathic Pharmacopoeia, official National Formulary, or any supplement to any of them, or otherwise established as drugs.70

Council on Naturopathic Physicians Formulary (3) The council established under subsection (1) of this section shall determine the substances to be included in the formulary that may be prescribed by a naturopathic physician acting under ORS 685.010 (3). The council shall review the formulary periodically. Immediately upon adoption or revision of the formulary, the council shall transmit the approved formulary to the board which must adopt the formulary by rule. When determined to be appropriate to the scope of practice of naturopathic physicians, the Council on Naturopathic Physicians Formulary may also consider synthetically produced substances and their salts having an identical or substantially identical molecular structure to a plant or animal substance as found in nature to be plant or animal

The formulary72 (June, 2008) differentiates drugs that may be prescribed from drugs that NDs may use on patients.

68 http://www.leg.state.or.us/ors/685.html69 http://www.leg.state.or.us/ors/685.html 70 http://www.leg.state.or.us/ors/685.html

http://www.leg.state.or.us/ors/685.html




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substances. From a 2007 report71 submitted to the California legislature by the Bureau of Naturopathic Medicine, California Department of Consumer Affairs: Oregon NDs have wide prescribing authority. All substances on the formulary are recommended by the formulary council and approved by the State Board of Naturopathic Examiners. From the Rules 850-060-0215 Drug Enforcement Administration Registration (1) Licensees may register with the United States Department of Justice for the issuance of a Drug Enforcement Administration (DEA) Number. (2) Licensees with DEA registration have authority to prescribe from Schedules II, III, IIIN, IV and V, only those drugs as listed on the Formulary compendium, OAR 850-060-0225. (3) Licensees shall not prescribe from Schedules II, III, IIIN, IV and V without a current DEA registration. 850-060-0220 Authority to Prescribe, Dispense, and Order Naturopathic physicians shall be allowed to prescribe, dispense, and order the following: (1) All substances recommended by the Formulary Council and approved by the Board.

(a) All biological substances including extracts and/or their products and residues. (b) All topical preparations.

(2) All vitamins, minerals, trace minerals, enzymes, and food. (3) All mechanical devices, except those that require major surgical intervention. (4) All homeopathic preparations. (5) All laboratory and diagnostic procedures.

Utah

No authority to prescribe or administer prescription drugs

NDs are regulated under Title 58, Ch.71 of the Utah Code.73

(11) "Naturopathic physical medicine" means the use of the physical agents of air, water, heat, cold, sound, light, and electromagnetic nonionizing radiation, and the physical modalities of electrotherapy, biofeedback, acupuncture, diathermy, ultraviolet light, ultrasound, hydrotherapy, naturopathic mobilization therapy, and exercise. Naturopathic medicine does not include the

The formulary was75 updated in 2008.

71 http://www.naturopathic.ca.gov/formspubs/formulary_report.pdf72 http://www.oregon.gov/OBNE/rules/850-060-0225.pdf 73 http://le.utah.gov/~code/TITLE58/58_71.htm


http://www.oregon.gov/OBNE/rules/850-060-0225.pdf


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practice of physical therapy or physical rehabilitation.74

(12) "Practice of naturopathic medicine" means: (12) "Practice of naturopathic medicine" means: (a) a system of primary health care for the prevention, diagnosis, and treatment of human health conditions, injuries, and diseases that uses education, natural medicines, and natural therapies, to support and stimulate the patient's intrinsic self-healing processes: (i) using naturopathic childbirth, but only if: (A) the licensee meets standards of the American College of Naturopathic Obstetricians (ACNO) or its successor as determined by the division in collaboration with the board; and (B) the licensee follows a written plan for naturopathic physicians practicing naturopathic childbirth approved by the division in collaboration with the board, which includes entering into an agreement with a consulting physician and surgeon or osteopathic physician, in cases where the scope of practice of naturopathic childbirth may be exceeded and specialty care and delivery is indicated, detailing the guidelines by which the naturopathic physician will: (a) a system of primary health care for the prevention, diagnosis, and treatment of human health conditions, injuries, and diseases that uses education, natural medicines, and natural therapies, to support and stimulate the patient's intrinsic self-healing processes: (i) using naturopathic childbirth, but only if: (A) the licensee meets standards of the American College of Naturopathic Obstetricians (ACNO) or its successor as determined by the division in collaboration with the board; and (B) the licensee follows a written plan for naturopathic physicians practicing naturopathic childbirth approved by the division in collaboration with the board, which includes entering into an agreement with a consulting physician and surgeon or osteopathic physician, in cases where the scope of practice of naturopathic childbirth may be exceeded and specialty care and delivery is indicated, detailing the guidelines by which the naturopathic physician will: (I) refer patients to the consulting physician; and (II) consult with the consulting physician; (ii) using naturopathic mobilization therapy; (iii) using naturopathic physical medicine; (iv) using minor office procedures;

Natural medicine" means76: (a) food, food extracts, dietary supplements as defined by the federal Food, Drug, and Cosmetics Act, all homeopathic remedies, and plant substances that are not designated as prescription drugs or controlled substances; (b) over-the-counter medications; (c) other nonprescription substances, the prescription or administration of which is not otherwise prohibited or restricted under federal or state law; and (d) prescription drugs:

74 http://www.naturopathic.ca.gov/formspubs/formulary_report.pdf 75 http://www.rules.utah.gov/publicat/bulletin/2008/20081015/31967.htm 76 http://le.utah.gov/~code/TITLE58/htm/58_71_010200.htm


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(v) prescribing or administering natural medicine; (vi) prescribing medical equipment and devices, diagnosing by the use of medical equipment and devices, and administering therapy or treatment by the use of medical devices necessary and consistent with the competent practice of naturopathic medicine; (vii) prescribing barrier devices for contraception; (viii) using dietary therapy; (ix) taking and using diagnostic x-rays, electrocardiograms, ultrasound, and physiological function tests; (x) taking of body fluids for clinical laboratory tests and using the results of the tests in diagnosis; (xi) taking of a history from and conducting of a physical examination upon a human patient; and (xii) prescribing and administering natural medicines and medical devices, except a naturopathic physician may only administer: (A) a prescription drug, as defined in Section 58-17b-102, in accordance with Subsection (8)(d) [see rightmost column for details],and (B) local anesthesia that is not a controlled substance, and only in the performance of minor office procedures; (b) to maintain an office or place of business for the purpose of doing any of the acts described in Subsection (12)(a), whether or not for compensation; or (c) to use, in the conduct of any occupation or profession pertaining to the diagnosis or treatment of human diseases or conditions, in any printed material, stationery, letterhead, envelopes, signs, or advertisements, the designation "naturopathic physician," "naturopathic doctor," "naturopath," "doctor of naturopathic medicine," "doctor of naturopathy," "naturopathic medical doctor," "naturopathic medicine," "naturopathic health care," "naturopathy," "N.D.," "N.M.D.," or any combination of these designations in any manner that might cause a reasonable person to believe the individual using the designation is a licensed naturopathic physician. (13) "Prescription drug or device" means: (a) a drug or device which, under federal law, is required to be labeled with either of the following statements or their equivalent: (i) "CAUTION: Federal law prohibits dispensing without prescription"; or (ii) "CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian"; or (b) a drug or device that is required by any applicable federal or state law or rule to be dispensed on prescription only or is restricted to use by practitioners only.

(i) that are not controlled substances as defined in Section 58-37-2; (ii) the prescription of which is consistent with the competent practice of naturopathic medicine; and (iii) the prescription of which is approved by the division in collaboration with the naturopathic formulary advisory peer committee


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From a 2007 report submitted to the California legislature by the Bureau of Naturopathic Medicine, California Department of Consumer Affairs: �Utah NDs are allowed to prescribe noncontrolled drugs that are consistent with competent practice of naturopathic medicine and are approved in collaboration with the Naturopathic Formulary Advisory Peer Committee.

Vermont Office of Professional Regulation Naturopathic Physicians Advisors

Prescribing and Administering

NDs are regulated under Title 26, Professions and Occupations, Ch.81, Naturopathic Physicians77

Scope of Practice78 (8) "Naturopathic medicine" or "the practice of naturopathic medicine" means a system of health care that utilizes education, natural medicines and natural therapies to support and stimulate a patient's intrinsic self-healing processes and to prevent, diagnose and treat human health conditions and injuries. In connection with such system of health care, an individual licensed under this chapter may: (A) Administer or provide for preventative and therapeutic purposes nonprescription medicines, topical medicines, botanical medicines, homeopathic medicines, counseling, hypnotherapy, nutritional and dietary therapy, naturopathic physical medicine, naturopathic childbirth, therapeutic devices, barrier devices for contraception, and prescription medicines authorized by this chapter or by the formulary established under subsection 4125(c) of this title. (B) Use diagnostic procedures commonly used by physicians in general practice, including physical and orificial examinations, electrocardiograms, diagnostic imaging techniques, phlebotomy, clinical laboratory tests and examinations, and physiological function tests. (9) "Naturopathic physical medicine" means the use of the physical agents of air, water, heat, cold, sound and light, and the physical modalities of electrotherapy, biofeedback, acupuncture, diathermy, ultraviolet light, ultrasound, hydrotherapy and exercise. "Naturopathic physical medicine" also includes naturopathic manipulation and mobilization therapy if, in the opinion of the director, the naturopathic physician's education emphasized the importance of the

The formulary79 is established by the Commissioner of Health with the advice of advisor appointees.

77 http://www.leg.state.vt.us/statutes/sections.cfm?Title=26&Chapter=081 78 http://www.leg.state.vt.us/statutes/fullsection.cfm?Title=26&Chapter=081&Section=04121 79 http://healthvermont.gov/regs/naturopath_rules.pdf


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neuromusculoskeletal structure and manipulative therapy in the maintenance and restoration of health. Naturopathic medicine does not include the practice of physical therapy, physical rehabilitation or chiropractic. (11) "Prescription medicine" means any human drug, including finished dosage forms and active ingredients subject to Section 503(b) of the federal Food, Drug and Cosmetic Act, required by federal law or regulation to be dispensed only by prescription. 4125. Director; duties (c) At least annually, in consultation with the commissioner of health and in accordance with consultation procedures adopted by the director by rule, the director with the advice of the advisor appointees, shall review and update the formulary of prescription medicines naturopathic physicians may use consistent with their scope of practice and training. Nonnatural substances found to be substantially safer in treatment or without which a patient's primary care would be compromised may be added to the formulary.

Washington Naturopathic Physician Medical Board

Prescribing and Administering

NDs are regulated under Title 18, Chapter 18.36A of the Revised Code of Washington

Scope of Practice (12) "Minor office procedures" means care and procedures incident thereto of superficial lacerations, lesions, and abrasions, and the removal of foreign bodies located in superficial structures, not to include the eye; and the use of antiseptics and topical or local anesthetics in connection therewith. "Minor office procedures" also includes intramuscular, intravenous, subcutaneous, and intradermal injections of substances consistent with the practice of naturopathic medicine and in accordance with rules established by the secretary. Naturopathic medicine is the practice by naturopaths of the art and science of the diagnosis, prevention, and treatment of disorders of the body by stimulation or support, or both, of the natural processes of the human body. A naturopath is responsible and accountable to the consumer for the quality of naturopathic care rendered. The practice of naturopathic medicine includes manual manipulation (mechanotherapy), the prescription, administration, dispensing, and use, except for the treatment of malignancies, of nutrition and food science, physical modalities, minor office procedures, homeopathy, naturopathic medicines, hygiene and immunization, nondrug contraceptive devices, common diagnostic procedures, and suggestion; however, nothing in this chapter shall prohibit consultation and treatment of a patient in concert with a practitioner licensed under chapter 18.57 or 18.71 RCW.

(10) "Naturopathic medicines" means vitamins; minerals; botanical medicines; homeopathic medicines; hormones; and those legend drugs and controlled substances consistent with naturopathic medical practice in accordance with rules established by the secretary. Controlled substances are limited to codeine and testosterone


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No person licensed under this chapter may employ the term "chiropractic" to describe any services provided by a naturopath under this chapter.

products that are contained in Schedules III, IV, and V in chapter 69.50 RCW80 [see below].

80 http://apps.leg.wa.gov/RCW/default.aspx?cite=69.50

Documents

Drug - Naturopathy Jurisdictional Review · Naturopathic Physicians of British Columbia Prescribing authority pending the approval of by-laws created by the College board. NDs are