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Reactions mixed to law that lets psychologists prescribe

There is mixed reaction from pharmacists in New Mexico where a controversial law goes into effect July 1 that gives authority for the first time to licensed psychologists to prescribe drugs. Several doctors and officials of the American Psychiatric Association have complained that the new law does not require enough training.

New Mexico is the first state to approve this kind of authority for psychologists, and similar legislation has been introduced in another six states. Supporters of the legislation in New Mexico say it requires psychologists to have a doctorate degree; complete 450 hours of classroom hours in pharmacology, neuroscience, or related fields; pass a national exam; and have 80 hours of clinical experience. They must also spend at least 400 hours treating at least 100 patients with mental disorders under the supervision of a psychiatrist or doctor.

While several psychiatrists said they don't want psychologists to have that kind of authority, some pharmacists also had concerns. "I wasn't too hot for it in the beginning," said Danny Cross, past president of the New Mexico Pharmaceutical Association. However, he maintained the new law, which has the support of Gov. Gary E. Johnson, is written to make psychologists qualified. "We don't have a problem with it now because there is a certain amount of training that is required," Cross said.

"I don't think they're qualified," said R.Ph. Hal Sims in Alamo Gordo, N.M. "The ones I deal with don't have a clue about drugs. They certainly need more education; once they get the education, that's fine." Sims also sees problems in the type of drugs for mental problems, which he described as "pretty potent. I see a potential for abuse, and that kind of bothers me."

The American Psychological Association said several studies have shown that psychologists could prescribe drugs safely. "In some conditions, the treatment of choice is a combination of psychotherapy and medication," said Russ Newman, executive director for professional practice at APA.

Others point out that New Mexico has a large rural population and a shortage of qualified doctors and psychiatrists. When doctors are not available, this law would help, said Tom White, a pharmacist in Albuquerque.

Jerry Montoya, chief inspector and executive director of the New Mexico Board of Pharmacy, said the board did not take a position on the measure before it became law. "Even if the psychologists are allowed to prescribe, they still have to be under the supervision of a medical doctor," Montoya said. There is a real shortage of practicing psychiatrists, and this makes it difficult for patients whose medications have to be adjusted."

Dale McCleskey, a pharmacist in Albuquerque, said the issue might be nullified by the fact that insurance companies may not recognize psychologists. "They won't pay for prescriptions by nurse practitioners," McCleskey said. "Some of these prescriptions are $200 or $300, so this law may be a moot point."

Jim Herman, a pharmacist in Clovis, N.M., said it was "upsetting" that psychologists now have the authority to prescribe when pharmacists have been trying to get the same authority. "We have infinitely more education" in pharmacology, he said. "We have been trying for several years, and our effort has met with little success."

Dennis Blank

The author is a writer in Orlando, Fla.

 

Dennis Blank. Reactions mixed to law that lets psychologists prescribe. Drug Topics 2002;8:22.