Section 56 Class Exemption for Paramedic Ambulance Technicians in Quebec

Pursuant to section 56 of the Controlled Drugs and Substances Act (CDSA), paramedics with the title of Paramedic Ambulance Technician in the province of Quebec are exempted for medical purposes from the application of the following provisions of the CDSA and its regulations:

• - Subsection 4(1) of the CDSA with respect to fentanyl, ketamine, morphine and pethidine
• - Subsections 5(1) and 5(2) of the CDSA with respect to diazepam, fentanyl, ketamine, lorazepam, midazolam, morphine and pethidine
• - Subsection 8(1) of the Narcotic Control Regulations with respect to fentanyl, ketamine, morphine and pethidine

In respect of this exemption,

• Controlled substance means one of the following substances: diazepam, fentanyl, ketamine, lorazepam, midazolam, morphine and pethidine.
• Paramedic means a person who is registered with the Quebec Ministry of Health and Social Services or a health and social service agency in accordance with the Emergency Pre-hospital Services Act (Quebec) to practice paramedicine as a Paramedic Ambulance Technician, and who is authorized under relevant policies and protocols established by Quebec Ministry of Health and Social Services to administer controlled substances as part of the practice of paramedicine.
• Unserviceable controlled substance means a drug product containing a controlled substance that is expired, contaminated, damaged, or any residual controlled substance remaining in a multi-dose vial.

This exemption provides the aforementioned paramedics with the authority to possess, transport and administer controlled substances when providing pre-hospital care to patients within their scope of practice as set out in relevant policies established by Quebec Ministry of Health and Social Services, and subject to the terms and conditions of this exemption.

The exemption is only applicable if the following conditions are met. Paramedics must:

1. Only administer controlled substances in accordance with the relevant protocols regarding the use of controlled substances as established by the Quebec Ministry of Health and Social Services, or under the direction of a medical practitioner designated by the National Directorate of Pre-hospital Emergency Services;
2. Record all transactions involving controlled substances, i.e., date, name and quantity of controlled substances obtained, administered or returned, and provide such a record to the hospital pharmacy that supplies the controlled substances, or the hospital pharmacy responsible for controlled substances, for record-keeping purposes;
3. Take necessary steps, in accordance with the guidelines concerning controlled substances established by Quebec Ministry of Health and Social Services, to ensure the security of the controlled substances in their possession, and in their ambulance or aircraft;
4. Report immediately to the originating hospital pharmacy, or the hospital pharmacy responsible for controlled substances, when they become aware of any loss or theft of controlled substances in their possession or in their ambulance or aircraft;
5. Return any unserviceable controlled substances to the originating hospital pharmacy; and
6. Obtain controlled substances only from the hospital pharmacy with which they are affiliated with respect to controlled substances.

This exemption will remain in effect until revoked. Failure to comply with the terms and conditions of this exemption may, among other things, result in immediate suspension of this exemption, and ultimately, in its revocation.

Signed for and on behalf of the Minister of Health

Original signed by

Carol Anne Chénard
Acting Director, Office of Controlled Substances
Controlled Substances Directorate
Health Canada

Effective Date: May 12, 2017