Updates on pharmaceutical prescribing for NDs in BC
 
As many of you probably still remember on April 9, 2009, the Government of British Columbia passed legislation to allow BC NDs to prescribe certain scheduled drugs. There are approximately 1100 scheduled drugs specified in the Drug Schedules Regulation of the Pharmacy Operations and Drug Scheduling Act of BC. NDs who successfully complete the BINM’s pharmaceutical upgrade course will gain prescription rights of up to 550 medications. Three cohort sessions of the course have been scheduled for this spring to accommodate 320 attendees and two sessions were completed so far. The prescription right is designed to be less than MDs but more than nurse practitioners or midwives. Naturopathic physicians must meet requirements for ongoing registration, including meeting continuing competency and quality assurance requirements. These requirements are currently undergoing further development in concert with the current initiative.
 
So what CAN NDs in BC prescribe?
Everything under the Schedule l drugs EXCEPT for the following:

1. Agents for Acute Perinatal Care
2. Antiviral agents
3. Antineoplastic Agents
4. Anticonvulsants
5. Antiparkinsonism Agents
6. Antipsychotic Agents
7. Antiarrhythmic agents
8. Antitubercular agents used for other infections
9. Botulinum toxin types A & B
10. Certain agents used for ‘Emergency Purposes Only’
11. Disease Modifying Agents
12. Emergency Medicine Agents
13. Endocrine Agents / Endocrine Diagnostic Agents
14. Parenteral iron products
15. Parenteral antibiotics
16. Obstetrical Agents Out-Patient Setting 
17. Ophthalmic Agents
18. Thrombolytic, Hemostatic and Anti-platelet Agents
19. Controlled drugs such as the followings:
20. Schedule I: Narcotic drugs such as opium, morphine and cocaine.
21. Schedule II: Cannabis, hashish, cannabinol, etc.
22. Schedule III: Stimulants such as amphetamines, hallucinogenics, such as mescaline, LSD and DET, and sedatives such as methaqualone, commonly called quaalude.
23. Schedule IV: Among others, anabolic steroids (including testosterone), hypnotics such as barbiturates and benzodiazepines.
24. Schedule V: Enumerates other substances that may be abused.
25. Schedule VI: Precursors, which produce no effects on the mind but can be converted or used to produce designer drugs, "simili-drugs" or substances contained in the schedules under Canada's international obligations under the Single Convention on Narcotic Drugs (1961) and the Vienna Convention of 1988.
26. Schedules VII and VIII: Concerning application of penalties for cannabis offences. 

And what is left?
LOTS!!

1. Analgesics
2. Antispasmodics
3. Antidiabetic agents
4. Antibiotics (po & topical)
5. Antidepressants
6. Antilipidemics
7. Antihypertensives
8. Botanicals
9. Dermatological agents
10. Hormones
11. Scheduled vitamins, minerals & amino acids 

Use of more than one scheduled item for advanced practices
NDs who are certified in chelation, prolotherapy, bio-oxidative therapies or other advanced practices are authorized to compound and use more than one scheduled substance if this is required by an established treatment protocol. Established treatment protocols may involve the use of the following scheduled items:
 
Chelation
Injectable vitamins/minerals
 
Intravenous Therapy
Injectable vitamins/minerals and amino acids
 
Prolotherapy
Authorized anaesthetics
Dextrose
Sodium morrhuate
P2G (Phenol, glycerin, dextrose)
Growth hormone
Hyaluronic acid injectable
Glucosamine sulfate injectable
 
Bio-oxidative therapy
Heparin
Sodium citrate 
  
Drug Schedules Regulation of the Pharmacy Operations and Drug Scheduling Act of BC may be found at: http://www.bcpharmacists.org/library/D-Legislation_Standards/D-4_Drug_Distribution/5012-Drug_Schedules_Regulation.pdf
 
More information on BINM‘s Pharmaceutical Prescribing Upgrade may be found at: http://www.binm.org/professional-pharmaceutical-upgrade.html