Subsection 56(1) Class Exemption for advanced care, critical care, primary care paramedics and infant transport paramedics in British Columbia

Pursuant to subsection 56(1) of the Controlled Drugs and Substances Act (CDSA), paramedics licensed in the category of Advanced Care Paramedic, Critical Care Paramedic, Primary Care Paramedics or Infant Transport Team in the province of British Columbia are exempted for medical purposes from the application of the following provisions of the CDSA :

• Subsection 4(1) of the CDSA with respect to buprenorphine, fentanyl, hydromorphone, ketamine, morphine and oxycodone.
• Subsections 5(1) and 5(2) of the CDSA with respect to buprenorphine, diazepam, fentanyl, hydromorphone, ketamine, lorazepam, midazolam, morphine, oxycodone and phenobarbital.

In respect of this exemption,

• British Columbia Ambulance Service (BCAS) means the agency that bears the name "British Columbia Ambulance Service" and provides ambulance services under the authority of the British Columbia Emergency Health Services in accordance with the British Columbia Emergency Health Services Act.
• Controlled substance means one of the following substances: buprenorphine, diazepam, fentanyl, hydromorphone, ketamine, lorazepam, midazolam, morphine, oxycodone and phenobarbital.
• Designated Administrator means a BCAS Medical Director who is ultimately responsible for ordering, transporting, storing and providing controlled substances for a BCAS region, or a physician designated in writing by such a Medical Director to act on his or her behalf for the purposes of this exemption.
• Designated Pharmacy means a pharmacy that is authorized to operate in the province of British Columbia by a pharmacy licence issued under the British Columbia Pharmacy Operations and Drug Scheduling Act, and whose owner has a contractual agreement with the BC Emergency Health Services for the supply of controlled substances to paramedics in the province of British Columbia.
• Licensed Dealer means the holder of a dealer’s licence issued under Narcotic Control Regulations, the Food and Drug Regulations – Part G, or the Benzodiazepines and Other Targeted Substances Regulations.
• Paramedic means a person who is licensed as an emergency medical assistant under the British Columbia Emergency Health Services Act and the Emergency Medical Assistants Regulation in the category of Advanced Care Paramedic, Critical Care Paramedic, Primary Care Paramedic or Infant Transport Team, and who is authorized under that legislation to administer controlled substances in the course of practising as an emergency medical assistant in the province of British Columbia.
• 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 in the course of providing services to patients within their licensed scope of practice under the British Columbia Emergency and Health Services Act and the Emergency Medical Assistants Regulation, in accordance with the direction of a practitioner designated by the BCAS and/or the relevant guidelines established by the BCAS, and subject to the terms and conditions of this exemption.

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

1. Administer all controlled substances in accordance with the direction of a practitioner designated by the BCAS and/or pre-approved guidelines established by the BCAS;
2. Keep a record of the following information for a two-year period beginning on the day on which the record is made and provide such a record to the Designated Administrator for record-keeping purposes;
   1. the name and quantity of any controlled substance purchased, received and returned and the date on which it was purchased, received and returned;
   2. the name and address of the person from whom the controlled substance was purchased, received and returned to; and
   3. particulars of the use to which the controlled substance was put.
3. Take necessary steps, in accordance with guidelines established by the BCAS, to ensure the security of controlled substances on their person and in their emergency vehicle or aircraft;
4. Report immediately to a Designated Administrator, in the form and manner required by the Designated Administrator, when they become aware of any loss or theft of controlled substances in their possession or in their emergency vehicle or aircraft;
5. Return any unserviceable controlled substances to a Licensed Dealer or a Designated Pharmacy, in the manner agreed between a Licensed Dealer or a Designated Pharmacy and the Designated Administrator for the BCAS region in which the Licensed Dealer or the Designated Pharmacy is located; and
6. Obtain controlled substances only from a Licensed Dealer or a Designated Pharmacy, in the manner agreed between the Licensed Dealer or Designated Pharmacy and the Designated Administrator for the BCAS region.

This exemption replaces the "Subsection 56(1) Class Exemption for Advanced Care, Critical Care, Primary Care Paramedics and Infant Transport Team Paramedics in British Columbia" that was issued on March 4, 2022. This exemption will remain in effect until the date on which this exemption has been replaced or the date on which this exemption is revoked.

The Minister may at any time and for any reason revoke or change the terms and conditions of this exemption. Should this be the case, you will be informed in writing and reasons for the revocation or changes will be provided.

A suspension of this exemption without prior notice may be ordered if the Minister deems that such a suspension is necessary to protect public health, safety or security.

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 Mental Health and Addictions and Associate Minister of Health.

Jennifer Saxe
Director General
Controlled Substances Directorate
Health Canada

Effective Date: October 14, 2014

Updated on: April 6, 2023