This notice was developed by CNO (College of Nurses of Ontario) and is supported by the Ontario College of Pharmacists.
On November 21, 2012, the federal government approved new regulations under the Controlled Drugs and Substances Act that remove federal restrictions on NP authority to prescribe controlled substances.
The following questions and answers address the key points related to Ontario NPs' authority to prescribe controlled substances, including narcotics.
Which medications are controlled substances?
A controlled substance is one that is included in Schedule I, II, III, IV or V of the Controlled Drugs and Substances Act.
Do Ontario NPs currently have the legal authority to prescribe controlled substances?
No. Regulations under the Ontario Nursing Act, 1991 specifically prohibit NPs from prescribing controlled substances.
Therefore, it is illegal for NPs to prescribe controlled substances.
Could directives be used as an authorizing mechanism for prescribing controlled substances?
No. Directives cannot be used for controlled substances. To meet the needs of their client population, NPs are required to work within existing legislation to ensure access to appropriate resources, such as authorized prescribers.
Will NPs have the legal authority to prescribe controlled substances in the future?
Yes, but only after Ontario regulations have taken effect.
The federal government recently approved new regulations under the Controlled Drugs and Substances Act that remove federal restrictions on NP authority to prescribe controlled substances. This law will not take effect in Ontario because provincial law prohibits NPs from prescribing controlled substances.
NPs will not have the legal authority to prescribe controlled substances until regulations under the Nursing Act, 1991 are revised.
CNO will work with members, stakeholders and the Ministry of Health and Long-Term Care to revise the current Ontario regulations in a way that protects the public interest and is consistent with current provincial priorities, including Ontario’s Narcotics Strategy.
Where can I find information about Ontario’s Narcotics Strategy?
Information about Ontario's Narcotics Strategy and the Narcotics Safety and Awareness Act, 2010 can be found on the Ministry of Health's website.
As part of the Narcotics Strategy, the province has established the Narcotics Monitoring System (NMS) to monitor the prescribing and dispensing of controlled substances. The primary purpose is to examine drug utilization patterns to inform harm reduction strategies, education initiatives, and improve prescribing and dispensing practices related to monitored drugs. If there is suspected illegal activity or professional misconduct, the NMS may report to law enforcement and to regulatory colleges. The NMS monitors any drug that is an opioid irrespective of whether it is listed under the Controlled Drugs and Substances Act.
CNO will inform members about any future changes to NP prescriptive authority through The Standard and www.cno.org/np.
If you have any questions about NP prescriptive authority or NP practice, contact CNO's Practice Line at ppd@cnomail.org.
The Ontario College of Pharmacists may be reached at pharmacypractice@ocpinfo.com.