Naturopathic doctors say they are well-positioned to address Washington’s opioid crisis and provide comprehensive health care in rural areas of the state. But they argue state law needs to change in order for them to practice medicine to the fullest extent of their training.
Naturopathic doctors attend a four-year naturopathic medical school and are certified as primary care providers in Washington state, but like most states, they are not authorized to prescribe all medications here. . They are not licensed to prescribe drugs that are classified as “controlled substances” and can be used to treat conditions such as pain, anxiety, ADHD and sleep disorders.
A bill currently before the Washington State Legislature would change that. This is the latest version of a bill that naturopathic doctors in the state have championed for nearly a decade.
Angela Ross is a naturopathic physician and executive director of the Washington Association of Naturopathic Physicians. She said one of the big reasons for giving naturopathic doctors more prescribing powers is that it’s difficult to help people wean themselves off opioids without the power to prescribe them.
Dr. Ross and his colleagues say naturopathic doctors can treat pain by administering buprenorphine, a drug that reduces dependence on opioids, and using non-drug treatments such as breathing techniques and acupuncture, while gradually reducing the prescribed amount of opioids. He said he hopes to help addicts by helping them manage their addictions. , dietary changes.
But to do that, Ross says naturopathic doctors need the authority to prescribe buprenorphine and opioids.
“We are uniquely positioned to provide truly comprehensive care to those struggling with addiction,” Ross said. “We will be following up with patients very closely.”
In 2009, Oregon gave naturopathic doctors the power to prescribe most drugs, including many controlled substances. It is one of the few states where they have this authority. However, a letter written by two naturopathic doctors in Oregon published in the journal Pain Medicine says that naturopathic doctors there continue to focus on non-drug treatments.
Ross said another reason for allowing naturopathic doctors to prescribe controlled substances is to increase access to health care in rural Washington.
In some remote areas, naturopathic doctors are filling the gap, and “they may be the only provider within a 100-mile radius,” she said.
In these locations, if a patient requires opioid painkillers after surgery or sleep medication during an episode of severe anxiety, “they are forced to drive for hours to get the treatment they need. It just puts a huge burden on patients,” she added.
The state Department of Health has overhauled naturopathic medicine training, stating in a report to Congress that naturopathic doctors do not have unlimited prescribing authority, but only a subset of controlled substances such as buprenorphine and anxiety. It recommended that the government be given the authority to prescribe. And sleeping pills. The report also recommends that naturopathic physicians be allowed to prescribe hydrocodone products (prescriptions lasting less than one week) for acute pain, but not for chronic pain management.
The primary opponent of giving naturopathic doctors broad prescribing authority is the Washington State Medical Association.
“A naturopathic physician’s educational emphasis on self-healing processes includes the comprehensive medical and pharmacological background necessary to properly and accurately prescribe potentially dangerous prescription drugs. No,” the association wrote on its website, detailing its opposition to the bill. (On a bill that would give psychologists some prescribing authority, give optometrists the ability to perform surgeries, and give nurses the same pay as doctors for the same services).
