What NDs can Prescribe

Under the Naturopathy Act, 2007, Registrants are authorised to perform the controlled act of “prescribing, dispensing, compounding or selling a drug designated in the regulations.”

The designated drugs are listed in Table 3 of the General Regulation below. Registrants may only prescribe the allowed drugs in accordance with any limitations outlined in the table.

When prescribing a drug, the general requirements for performing a controlled act outlined on the Controlled Acts page do not apply. Instead, the Regulation establishes the following requirements that Registrants must meet to prescribe a drug:

• The Registrant can only prescribe a drug to a patient.
• The drug can only be prescribed for therapeutic purposes.
• The Registrant must have sufficient knowledge skill and judgment about the drug and the patient’s condition to prescribe the drug.
• The Registrant must determine that the patient’s condition warrants the prescribed drug, having considered the risks and benefits of prescribing the drug and other circumstances relevant to the patient.
• The Registrant must notify the patient’s other primary health care providers that they have prescribed the drug for the patient and provide the details of the prescription within a reasonable amount of time, unless the patient does not consent to the disclosure.
• Where a limitation, route of administration or dosage is indicated in Table 3, the Registrant can only prescribe the drug in accordance with those conditions.

What is on a prescription?

Part II (Controlled Acts) of the General Regulation requires that a prescription contains the following:

• the name and address of the patient for whom the drug is prescribed;
• the name, strength (where applicable) and quantity of the prescribed drug;
• directions for use of the drug, including dose, frequency, route of administration and any special instructions;
• the name, signature, address, telephone number and College registration number of the Registrant issuing the instruction;
• the date the prescription was issued;
• the number of refills that the Registrant has authorised; and
• any other information required by law.

Registrants must maintain a patient record for individuals prescribed a drug that includes:

• details of the reason for prescribing the drug;
• a copy of the prescription given to the patient;
• a record of the results of any laboratory or other tests that the Registrant considered in deciding to prescribe the drug; and
• the names and addresses of the patient’s other health care providers who were notified, and how the notification was given.

Additional education and training

A Registrant may only prescribe a drug to a patient if they have met the Standard of Practice for Prescribing, which requires that they successfully complete a College approved course and examination in Therapeutic Prescribing. The College’s Naturopathic Doctor Register includes information about whether a Registrant has met this standard of practice.

When is a prescription not required?

A prescription is not required when a Registrant is recommending that a patient take a natural health product (but note below that certain natural health products have been identified as drugs). Such natural health products include the following:

• a plant or plant material, an alga, a bacterium, a fungus or a non-human animal material;
• any extract or isolate of the above substances, or a synthetic duplicate;
• any of these vitamins, or a synthetic duplicate: biotin, folate (dosage dependent), niacin, pantothenic acid, riboflavin, thiamine, A (dosage dependent), B6, B12, C, D (dosage dependent), E, K1 (dosage dependent), and K2 (dosage dependent);
• an amino acid, or a synthetic duplicate;
• an essential fatty acid, or a synthetic duplicate;
• a mineral; or
• a probiotic.

Some natural health products have been identified as drugs, either entirely or based on certain dosages. A Registrant is expected to know when a substance is a drug by using the Prescription Drug List, made under the Food and Drugs Act (Canada) or National Association of Pharmacy Regulatory Authorities (NAPRA) Schedule 1.

What can be prescribed?

Substances on the Health Canada Prescription Drug List and the NAPRA Schedule 1 require a prescription. Of those substances, only the drugs listed on Table 3 of the General Regulation may be prescribed by a Registrant who has met the standard of practice for prescribing in accordance with the Standard of Practice for Prescribing.