Subsection 56(1) Class Exemption for Advanced Care and Critical Care Paramedics in Newfoundland and Labrador

Pursuant to subsection 56(1) of the Controlled Drugs and Substances Act (CDSA), paramedics with the title of Advanced Care Paramedics or Critical Care Paramedics in the province of Newfoundland and Labrador employed by regulated ambulance service operators 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, hydromorphone, ketamine, morphine and pethidine;
• Subsections 5(1) and 5(2) of the CDSA with respect to diazepam, fentanyl, hydromorphone, ketamine, lorazepam, midazolam, morphine and pethidine; and
• Subsection 8(1) of the Narcotic Control Regulations (NCR) with respect to fentanyl, hydromorphone, ketamine, morphine and pethidine.

In respect of this exemption,

• Controlled substance means one of the following substances: diazepam, fentanyl, hydromorphone, ketamine, lorazepam, midazolam, morphine and pethidine.
• Designated Administrator means a person who is in a managerial position and is ultimately responsible for ordering, transporting, storing and providing controlled substances to paramedics for an ambulance service operator governed under the Motor Carrier Act and the Motor Carrier Regulations (Newfoundland and Labrador), the relevant policies established by the Department of Health and Community Services of Newfoundland and Labrador and its Provincial Medical Oversight Program.
• Paramedic means a person who is registered and entitled under the Provincial Medical Oversight Program in accordance with the Health and Community Services Act (Newfoundland and Labrador) and Regional Health Authorities Act (Newfoundland and Labrador) to practice as an Advanced Care Paramedic or Critical Care Paramedic in that province and to administer controlled substances as part of the practice of paramedicine, and who is employed by ambulance service operators governed under the Motor Carrier Act and the Motor Carrier Regulations (Newfoundland and Labrador), the relevant policies established by the Newfoundland and Labrador Department of Health and Community Services and its Provincial Medical Oversight Program.
• Unserviceable stock means drug product containing a controlled substance that is unusable, expired and/or that cannot be dispensed. 

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 protocols established by the Eastern Health Authority on behalf of the Department of Health and Community Services of Newfoundland and Labrador, 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 controlled substances in accordance with the direction of a practitioner and/or the relevant protocols established by the Eastern Health Authority on behalf of the Department of Health and Community Services of Newfoundland and Labrador;
2. Record all transactions involving controlled substances, i.e., date, name and quantity of controlled substances obtained, administered and returned, and provide such a record to the Designated Administrator for record-keeping purposes;
3. Take necessary steps, in accordance with guidelines established by the Department of Health and Community Services of Newfoundland and Labrador, to ensure the security of the controlled substances on their person, in their ambulance or aircraft;
4. Report immediately to the Designated Administrator when they become aware of any loss or theft of controlled substances on their person or in their ambulance or aircraft;
5. Return any unserviceable stock to the Designated Administrator who supplies the controlled substances; and
6. Obtain controlled substances only from the Designated Administrator of the regulated ambulance service operator with which they are affiliated.

This exemption replaces the "Section 56 Class Exemption for Advanced Care and Critical Care Paramedics in Newfoundland and Labrador" that was issued on July 12, 2010. 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.

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 the behalf of the Minister of Health,

Michelle Boudreau
Director General
Controlled Substances Directorate
Health Canada

Effective Date:  April 8, 2019