Natalie Valentino, PharmD, BCPP
VA Salt Lake City Healthcare System
Natalie Valentino is a psychiatric clinical pharmacist practitioner at the VA Salt Lake City Health Care System (VASLCHCS). She completed her pharmacy education at the University of Pittsburgh College of Pharmacy and graduated from the Salt Lake City VA’s PGY1 and PGY2 Psychiatry residency programs. Since 2017, Dr. Valentino has been employed as a substance use disorder pharmacist embedded within primary care at the Salt Lake City VA. As a member of the Vulnerable Veteran Innovative PACT, a specialty addiction medicine primary care team, she performs medication management for a variety of substance use disorders, including prescribing buprenorphine for opioid use disorder utilizing her DEA license. Her passion for harm reduction led her to serve as her local harm reduction coordinator, working with stakeholders to develop and operate a syringe services program within primary care. In October 2024, she was selected for a year-long special assignment with the HIV, Hepatitis and Related Conditions office as the National Harm Reduction Coordinator tasked with expanding access to and education on harm reduction resources and syringe services programs within the Veterans Health Administration. In addition to her patient care and program coordination duties, she also values mentorship and serves as mentor and preceptor to pharmacy residents at her facility. In her free time, she can be found traveling for live music, in the mountains snowboarding or mountain biking, or cooking for friends and family.
Why did you decide to get your DEA license?
My clinical practice centers around medication management of substance use disorders, including buprenorphine for opioid use disorder (OUD). My role includes independently initiating, monitoring, adjusting and discontinuing these medications through a scope of practice at my Veterans Affairs facility, similar to a collaborative practice agreement. With the removal of the X-waiver for prescribing buprenorphine for OUD, I was highly motivated to obtain my DEA to improve the efficiency of my workflow and practice with greater independence. Prior to obtaining my DEA license, my workflow included staffing my plans of care with prescribers on my team and entering orders for controlled substance for signature under their license. This often presented a significant time barrier and delay of care, as my teammates were usually in visits with their own patients. Additionally, once understanding and trust were established with my teammates, minimal staffing occurred prior to them signing off on orders. Based on this, I felt confident in my clinical decision-making capacity to prescribe controlled substances under my own license rather than under my colleagues’ licenses.
Lastly, I felt that having my DEA license and experience with prescribing controlled substances would increase my marketability when applying for future employment or looking to advance my career. With some positions, having your DEA license or other certifications may not only be required, but may be factored into advocating for negotiating a higher salary or other financial incentives.
How did you obtain your DEA license?
I first contacted colleagues who had already obtained their DEA licensure to determine what steps they took and ask for contact information for anyone who assisted them in the process. Next, I confirmed with the Board of Pharmacy in the state in which I am licensed that it was legal for me to apply for and utilize a DEA license for prescribing controlled substances. Through these conversations, I also confirmed the scope of my DEA license. For example, I am only able to utilize my DEA license for prescribing at any site within the Veterans Affairs health system . Once confirming this, I established with my supervisor, department, and facility that I would be permitted to utilize a DEA license within my practice to prescribe and manage controlled substances. One thing that facilitated these conversations was precedent already existed within the Veterans Affairs for pharmacists to prescribe controlled substances. With support from my local facility, I next contacted one of our regional DEA representatives to review the application process to ensure I was applying for the correct licensure and prepared all the appropriate documentation requirements. Pharmacists are considered mid-level practitioners with regards to DEA licensure, and should apply for an M-level license. If practicing within a federal agency, apply for a federal-specific DEA licensure. This means that your DEA license is limited for use within federal health care systems and has no application fee. After applying and being awarded my DEA license, I then concluded with notifying my supervisor and credentialing office to update my licensure and electronic medical record access to now allow me to independently manage controlled substances.
What information would be helpful to know if I’m considering getting my DEA license?
I would recommend starting with confirming whether the state in which you are licensed and/or practice allows you to obtain your DEA license. Additionally, I would also confirm early on whether your practice site would allow you to utilize a DEA license within your clinical practice. Knowing whether there is precedent to do so in your state or organization is helpful in facilitating these conversations. Consider asking your supervisor or board of pharmacy whether precedent has been established in your state or organization. If there is any question, it’d be reasonable to contact your organization’s legal team for their input as well. This would also be an appropriate time to determine whether there are any financial incentives to obtaining your DEA license within your facility and the process for advocating for them. I asked my supervisor for information on this as well as other pharmacists within my organization through a psychiatric pharmacists email group.
My colleagues were instrumental in my decision to obtaining my DEA license. My interdisciplinary team members support in incorporating this into my practice and tips from my pharmacist colleagues who had already obtained their DEA license helped me feel confident and supported throughout the application process. It would be helpful to know what support is available in obtaining your DEA license and incorporating it into your practice. Talk to your pharmacist colleagues who have already done this because they may have suggestions and have contacts within the Board of Pharmacy, DEA regional office or your organization to help the application process go smoothly. These colleagues may also be helpful in talking through the transition of prescribing these medications under your own license rather than a colleagues. Your interdisciplinary teammates within your practice may also help serve as advocates if there are barriers to approval within your facility or organization. I was surprised how quickly the novelty and intimidation of prescribing controlled substances under my own name subsided. Having closely managed many of these medications for several years and knowing I had still has support with challenging cases helped grow my confidence and comfort with this transition.
