Understanding Drug Prescribing Scope for NDs: Practical Guidance for Your Practice
When determining whether a drug falls within the prescribing scope for a ND, the answer is not always straightforward. Prescribing decisions often require consideration of regulatory requirements, professional standards, and individual clinical competence. This overview is intended to support thoughtful and informed decision-making in practice.
Begin by Identifying What Is Clearly Out of Scope
practical first step is to identify drugs and substances that are explicitly excluded from ND prescribing.
Per the Clinical Practice Standard: Naturopathic Medicine Prescribing, Compounding and Dispensing Drugs, Principle 1, NDs must:
1.1 Hold current prescriptive authority certification with the College.
1.2 Prescribe:
1.2.1 in accordance with the BC Pharmacy Operations and Drug Scheduling Act and the federal Controlled Drugs and Substances Act and associated regulations.
1.2.2 as defined by the Complementary Health Professionals Regulation (the “Regulation”), including limits and conditions set out in the Regulation and in Appendix A to this Standard.
1.2.3 only drugs approved by Health Canada.
1.2.4 only with the appropriate knowledge, skills and competence.
NDs must not prescribe drugs that fall into the following categories:
- Substances listed in Schedule IA of the BC Drug Schedules Regulation
- Substances listed in any schedule of the federal Controlled Drugs and Substances Act
- Drugs identified in the Appendix of the Complementary Health Professionals Regulation
- Drugs or substances excluded in Appendix A of the Clinical Practice Standard: Naturopathic Medicine Prescribing, Compounding and Dispensing Drugs
- Drugs that have been newly approved by Health Canada but are under review by the CCHPBC
To support NDs, the College has developed a guidance document, the Schedule 1 Prescription Drug Inclusion List, which is available in the licensee portal. This inclusion list can be a helpful starting point when assessing whether a drug is within a ND’s scope of practice. If a drug does not appear on the Schedule 1 Prescription Drug Inclusion List and is not clearly captured in the exclusions noted above, it is advisable to contact the College for clarification before prescribing.
Refer to the Clinical Practice Standard: Naturopathic Medicine Prescribing, Compounding and Dispensing Drugs.
Prescribing decisions should be informed by the Clinical Practice Standard: Naturopathic Medicine Prescribing, Compounding and Dispensing Drugs. This clinical practice standard outlines an ND’s obligations with respect to drugs being prescribed, dispensed and compounded.
Regular review of this document can be especially helpful when considering new drugs or expanding prescribing activities.
Reflect on Professional Competence
Prescribing safely and within scope also requires consideration of clinical competence and depends on appropriate knowledge, training, and clinical judgment.
Per the Professional Standard: Scope of Practice: Principle 1, licensees must:
1.3 Only practice and provide care to patients when they have appropriate knowledge, skills, and competence.
1.4 Incorporate an evidence-based practice approach to support clinical-decision making when determining an appropriate treatment plan for a patient.
Before prescribing, NDs should ensure that they:
- Possess the clinical knowledge and competence required for safe prescribing
- Hold valid certification in prescriptive authority
- Are practising in alignment with all applicable professional obligations:
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- Complementary Health Professionals Regulation
- Bylaws
- Professional and Clinical Practice Standards
- Scope of Practice Explanatory Statement: Naturopathic Medicine
This reflective approach supports both patient safety and professional accountability.
Why This Matters
Maintaining awareness of prescribing scope supports safe patient care, promotes consistency in clinical practice, and helps uphold public confidence in the profession. It also ensures that prescribing practices remain aligned with current legislative and regulatory requirements.
Practice Tip for ND Licensees
Regular review of prescribing practices and consultation of Professional and Clinical Practice Standards and Schedule I Prescription Drug Inclusion List can help maintain confidence in clinical decision-making, especially when considering new drugs or expanding prescribing activities. When uncertainty arises, seeking clarification from the College before prescribing is a prudent step.
For questions related to scope of practice, NDs are encouraged to contact Practice Support at PracticeSupport@cchpbc.ca or by calling 604-742-6670, then pressing 2 followed by 1. Please select the option that corresponds to the relevant profession.
