Prescribing Authority: What it Means for Ontario's NDs
On November 30, the Ontario legislature gave final approval to Bill 179, which includes the amendment to the Naturopathy Act awarding Ontario NDs the controlled act of "prescribing, dispensing, compounding or selling a drug designated in the regulations." Awarding NDs prescribing authority was supported by all three political parties.
This amendment to include prescribing authority means that the Transitional Council for the future College of Naturopaths of Ontario now has the authority to develop advice for the Ontario government on the naturopathic formulary, and associated standards of practice to ensure safe practice. Prescribing authority will come into effect once the regulation of the profession moves under the Naturopathy Act at the end of the transition process. This is now expected to be in 2012.
The Importance of Prescribing Authority for NDs and Patients
Prescribing Authority ensures NDs and patients will have access to traditional substances that have become restricted or may become restricted in the future with the implementation of the NHP regulation, as well as clear authority to compound, dispense and sell these substances. Prescribing authority also creates the potential for NDs to have access to crash cart medications and a limited range of primary care substances.
Examples of the substances that NDs would have trouble accessing and using in clinical practice without prescribing authority include:
1. Write prescriptions for restricted natural substances
(e.g. belladonna obtained from a compounding pharmacy for irritable bowel syndrome)
2. Compound, dispense and sell non-Schedule I natural substances in clinic
(e.g. ephedra for asthma)
3. Order compounding by pharmacy
(e.g. compounded homeopathic preparations for injection)
4. Substances administered by injection or inhalation
(e.g. accessing and compounding parenteral therapy formulations)
5. Federally restricted substances
(e.g. Tryptophan for sleep, L-Carnitine for vascular health)
6. Emergency Kit Medications
(e.g. oxygen, diphenhydramine, salbutamol, epinephrine)
7. Legislative authority for continuing evolution of the profession
(e.g. first line primary care drugs like anti-bacterials, anti-fungals, topical agents)
Why Prescribing Authority Was Awarded
Securing this amendment is a major success for the profession, and the result of an intensive advocacy effort focused on demonstrating that NDs are primary care providers with the training and capability to play an increasingly significant role in addressing many critical issues facing the health care system in Ontario. An essential part of this is for NDs and patients to have secure access to substances integral to naturopathic medicine.
Prescribing authority for NDs was recommended in early 2009 by Ontario's Health Professions Regulatory Advisory Council in their Critical Links report. The need for prescribing authority recognizes the increasing restrictions in the regulation of natural substances, and the importance of preserving scope of practice to compound, dispense and sell. HPRAC also recognizes that NDs have the capability to take on a larger role in primary care with access to basic primary care pharmaceuticals. The report is available on the HPRAC website, click here to access it.
