Naturopathic doctors can prescribe at least some medications in roughly 20 states and the District of Columbia, but the scope of what they can prescribe varies dramatically from state to state. Some states grant broad prescribing rights that include controlled substances, while others limit naturopathic doctors to narrow formularies of natural products. A handful of states license naturopathic doctors but give them no prescribing authority at all.
States With the Broadest Prescribing Rights
A small group of states stands out for granting naturopathic doctors (NDs) wide prescribing authority, including access to at least some controlled substances. These are the states where NDs function most like primary care providers in terms of what they can prescribe.
Arizona allows NDs to prescribe controlled substances and other prescription drugs according to a board-approved formulary. NDs in Arizona can also dispense medications directly from their offices after completing specific training in safe administration. The state requires 10 hours of pharmacology continuing education each year to maintain this authority.
Washington gives NDs access to nearly all prescription (legend) drugs, with only a few exclusions like Botox and cosmetic injectables. Washington also permits NDs to prescribe limited controlled substances, specifically codeine and testosterone products in Schedules III through V. This makes Washington one of the most permissive states for naturopathic prescribing.
Oregon allows NDs to prescribe controlled substances and other prescription drugs per a naturopathic formulary. Vermont permits controlled substances that qualify as “natural medicines,” meaning they are not artificial or man-made, along with a broad list that includes antibiotics, antivirals, antifungals, hormones, vitamins, minerals, and botanicals. The District of Columbia similarly allows controlled substances if they qualify as natural medicine and are given through an appropriate route.
States With Moderate Prescribing Authority
Several states let NDs prescribe prescription medications but draw the line at controlled substances. The specific drugs available vary because each state maintains its own formulary.
California is a notable case. NDs there can prescribe herbs, nutrients, homeopathic remedies, and both natural and synthetic hormones. They also have access to Schedule IV and V controlled substances, but only under the supervision of a medical doctor or osteopath. Schedule III controlled substances require that same supervision. However, California carved out an exception for hormones: NDs can independently prescribe natural and synthetic hormones without any physician oversight.
Hawaii limits NDs to a naturopathic formulary that includes prescription vitamins, minerals, supplements, botanicals, homeopathic remedies, biological substances, and hormones (except testosterone). NDs there can also prescribe certain antibiotics and pain medications. No controlled substance authority exists.
Utah gives NDs access to non-controlled prescription drugs considered appropriate for primary care. That includes antihistamines, antibiotics, antifungals, antivirals, hormones (again, except testosterone), local anesthetics, cardiac medications, and oxygen, plus prescription vitamins, minerals, homeopathic products, botanicals, and thyroid glandulars.
Montana allows a detailed list of prescription items: antibiotics, antifungals, prescription hormones, whole gland thyroid, oxytocin, blood thinners, vaccines, barrier contraceptives, topical medicines, and several others. No controlled substance prescribing is permitted.
Kansas, Maine, and New Hampshire each restrict NDs to their own naturopathic formularies. Maine, for example, limits prescribing to homeopathic remedies, vitamins and minerals, hormones, local anesthesia, and immunizations as the board designates.
States That License NDs Without Prescribing Rights
Some states license or register naturopathic doctors but do not grant them any prescribing authority. Alaska, Minnesota, and North Dakota all fall into this category. NDs in these states can practice naturopathic medicine, which typically includes nutrition counseling, botanical recommendations, and lifestyle guidance, but they cannot write prescriptions for any legend drugs or controlled substances. Connecticut occupies a middle ground: NDs there are limited to oral, non-narcotic, non-prescription substances, which effectively means they lack meaningful prescriptive authority for pharmaceutical drugs.
Hormones and Thyroid Medications
Hormone prescribing is one of the most common reasons patients seek out naturopathic doctors, and most states with ND prescribing authority include hormones on their formularies. California, Montana, Vermont, Utah, Hawaii, and Maine all explicitly permit NDs to prescribe some form of hormones. California stands out for allowing both natural and synthetic hormones without requiring physician supervision, even though most other California ND prescribing does require an MD or DO to oversee the process.
Testosterone is a recurring restriction. Hawaii and Utah both specifically exclude testosterone from what NDs can prescribe, likely because testosterone is classified as a Schedule III controlled substance under federal law. Washington is an exception, explicitly permitting NDs to prescribe testosterone products in Schedules III through V. Thyroid medications, particularly whole gland thyroid preparations, are allowed in Montana and Utah.
How Formularies Work in Practice
Most states don’t give NDs an open-ended prescription pad. Instead, they use a formulary system: the state’s naturopathic board maintains a list of approved medications, and NDs can only prescribe from that list. These formularies are periodically updated, so the specific drugs available can change over time. In states like Washington, the formulary is “exclusionary,” meaning NDs can prescribe anything that isn’t specifically prohibited. In most other states, the formulary is “inclusionary,” meaning NDs can only prescribe what’s explicitly listed.
This distinction matters practically. An exclusionary formulary gives NDs far more flexibility and keeps their prescribing options current as new medications come to market. An inclusionary formulary requires the board to actively add each new drug, which can create delays.
States With No Naturopathic Licensing
The majority of U.S. states do not license naturopathic doctors at all. In those states, the title “naturopath” may not be legally protected, and individuals practicing naturopathic medicine have no state-granted prescribing authority. If you live in a state without ND licensing, anyone calling themselves a naturopath cannot legally prescribe medications regardless of their training. The approximately 20 states and jurisdictions that do license NDs represent a patchwork, concentrated heavily in the West and Northeast.
Because laws change regularly, checking your state’s naturopathic medical board or licensing authority for the most current formulary and scope of practice is the most reliable way to know exactly what an ND can prescribe where you live.