The NAP Clinical Safety and Practice Standards
Nutraceutical Assisted Programs
A Companion to the NAP Manifesto and Standards Council Charter Who May Practice NAP, the Safety Floor, and the Standards That Protect the Patient Michael Andrew Feller Jones Founder, Nutraceutical Assisted Programs Category
About This Document
A category of medicine earns trust not only through its evidence but through its safety. This document defines the non-negotiable safety floor of NAP practice: who is legally permitted to practice it, where NAP defers to conventional medicine without exception, how the category detects and responds to harm, and the quality standard the products used in NAP practice must meet.
These are not aspirations. They are the conditions of practicing within the NAP framework at all. A practitioner who does not meet them is not practicing NAP. The standards are deliberately conservative, because the fastest way to discredit a new medical category is a preventable harm, and the surest way to earn a regulator's trust is to show that the category polices its own safety more rigorously than it is required to.
This document is product neutral. It defines the standard, not the product.
PART I. SCOPE OF PRACTICE
1. The Licensed-Clinician Requirement
The NAP credential is an added qualification layered atop a primary clinical license — never a substitute for one. A NAP practitioner must hold a recognized clinical license in their jurisdiction (for example, physician, nurse practitioner, physician assistant, naturopathic physician where licensed, or another regulated clinical profession with the relevant scope), and the NAP credential certifies additional competency within that existing license.
The governing rule is simple and absolute: scope follows your license. A practitioner may do within NAP only what their primary license already permits them to do. The NAP credential confers no independent legal authority to diagnose, order or interpret laboratory testing, prescribe, or de-prescribe. Where an activity is a licensed medical act in a jurisdiction, only a clinician licensed for that act may perform it under NAP.
This requirement protects patients, protects practitioners from practicing outside their lawful scope, and protects the category from the single gravest legal risk a new clinical framework faces: the appearance of authorizing the unlicensed practice of medicine. NAP authorizes no such thing.
2. De-Prescribing Authority
De-prescribing — the structured reduction or discontinuation of a medication — is a medical act. Within NAP it is governed by one rule: only the clinician who can lawfully prescribe a medication may reduce or discontinue it, and only they may supervise that process. A NAP practitioner who is not a prescriber may identify de-prescribing opportunities, document them, and coordinate with the patient's prescribing clinician — but may never instruct a patient to alter a medication. De-prescribing is always gradual, always prescriber-supervised, and always undertaken with supportive terrain restoration in place.
3. Jurisdictional Compliance
NAP operates across many legal systems, and medicine is regulated locally. Every NAP practitioner and center practices in full compliance with the laws of their jurisdiction. Where local law is more restrictive than this standard, local law governs. The NAP Standards Council maintains guidance on jurisdictional variation, but the responsibility to practice lawfully rests with the credentialed practitioner. NAP accreditation is contingent on lawful practice and is withdrawn where it is absent.
PART II. THE ACUTE-CARE BOUNDARY
4. Terrain-First Is Not Terrain-Only
NAP is the foundational paradigm for chronic, multifactorial, terrain-driven conditions. It is not a model for acute, emergent, or immediately dangerous presentations, and it never delays the care those presentations require. The terrain-first principle applies to the chronic disease cascade. It does not apply to the patient in front of you who needs an emergency department now. In every NAP assessment, the first clinical act is to rule out the conditions that require immediate conventional or emergency care.
5. The Red-Flag Rule
The following presentations require immediate referral to conventional or emergency medical care, and NAP intervention never substitutes for or delays that referral:
- Chest pain, signs of stroke, severe shortness of breath, or other signs of cardiovascular or neurological emergency.
- Signs of sepsis or severe or rapidly worsening infection.
- Acute abdomen, severe uncontrolled bleeding, or acute trauma.
- Suicidal or homicidal crisis, acute psychosis, or acute danger to self or others.
- Severe, unexplained, or rapid weight loss; suspected malignancy; or other findings suggestive of serious undiagnosed disease.
- Acute intoxication, overdose, or dangerous withdrawal.
- Pregnancy complications, or any acute deterioration in a vulnerable patient.
This list is illustrative, not exhaustive. The principle behind it is absolute: when a presentation may be acutely dangerous, conventional and emergency medicine come first, every time. NAP's role resumes once the patient is safe.
6. Serious Mental Illness
For serious psychiatric illness — psychosis, bipolar disorder, acute suicidality — NAP supports and never replaces or delays psychiatric stabilization. Terrain restoration may proceed alongside conventional psychiatric care, in coordination with the treating psychiatric clinician, but it is never offered as a reason to withhold, delay, or discontinue stabilizing treatment. The crisis pathway and the Veterans Crisis Line and equivalent resources are foregrounded in every mental-health-related protocol.
PART III. PHARMACOVIGILANCE AND ADVERSE-EVENT REPORTING
7. The Duty to Report
Every credentialed NAP practitioner has an affirmative duty to report adverse events — any harm, suspected harm, or unexpected deterioration associated with a NAP intervention — to the NAP safety registry, promptly and completely. Reporting is a condition of credentialing, not an option. A category that cannot see its own harms cannot prevent them, and cannot be trusted by the regulators it asks to recognize it.
8. Herb–Drug Interaction Surveillance
Because NAP patients frequently take pharmaceuticals alongside botanical and nutraceutical interventions, herb–drug and nutrient–drug interactions are a primary safety concern. The NAP Standards Library maintains and continuously updates interaction guidance, every assessment includes a full medication and supplement reconciliation, and suspected interactions are reported to the safety registry like any other adverse event.
9. The Safety Signal Loop
Adverse-event data does not sit in a file. The NAP safety system operates a closed loop: reports are aggregated and reviewed by the Standards Council's safety function, signals trigger review and, where warranted, revision of protocols and contraindications in the Standards Library, and updated guidance and alerts are pushed to all credentialed practitioners. This is the mechanism by which NAP gets safer over time rather than merely larger. The safety registry interoperates with the Outcome Registry: harms are measured with the same rigor as benefits.
PART IV. PRODUCT QUALITY AND SOURCING STANDARD
10. The Quality Floor
NAP does not certify products, but it does define the quality standard any product used in NAP practice must meet. NAP-compliant products are:
- Identity-verified — confirmed to contain what they claim, by validated testing.
- Contaminant-tested — screened for heavy metals, microbial contamination, pesticide and solvent residue, and adulterants, to defined limits.
- Potency-defined — standardized or characterized so that what is delivered is known and reproducible.
- GMP-manufactured — produced under current good manufacturing practice.
- Third-party verified — quality confirmed by an independent party, not by the seller alone.
11. The Contamination Standard Exists for a Reason
The natural products industry is a documented source of the very contaminants NAP works to remove — heavy metals, undisclosed adulterants, and inconsistent potency appear in commercial supplements with troubling frequency. A framework that reduces toxic burden cannot, in good conscience, deliver interventions that add to it. The quality floor is therefore not bureaucratic; it is clinical. A NAP protocol delivered through an untested product is not a NAP protocol.
12. Product Neutrality and Quality Together
NAP certifies the standard, not the brand. No product, manufacturer, or organization — including any under the founder's direction — receives preferential standing within the NAP framework, consistent with the Manifesto's Pledge and the Charter's conflict-of-interest provisions. Any product, from any source, that meets the quality floor may be used in NAP practice; any product that does not, may not, regardless of its origin.
PART V. SCOPE OF THIS STANDARD
These standards are the safety floor of NAP practice, not its ceiling. They are binding on every credentialed practitioner and accredited center, they are enforced through the credentialing and accreditation process governed by the Charter, and they are maintained and updated by the NAP Standards Council as evidence and experience accumulate. They integrate with the Clinical Assessment Framework, the Standards Library protocols, and the Outcome Registry, which together define how NAP is practiced, measured, and kept safe.
A practitioner who honors the evidence but not the safety floor is not practicing NAP. Both are the standard.
CLOSING
Trust in a new medicine is built twice: once through what it can do, and once through the harm it refuses to cause. This document is the second. It binds NAP to practice within the law, to defer without hesitation when a patient needs conventional or emergency care, to see and act on its own adverse events, and to deliver only what has been tested to be clean. These are the conditions under which a natural medicine framework deserves to be called a standard — and the conditions under which patients are safe within it.