Section 56 Class Exemption for Medical Directors of Land System and Air Medical Response System Licence Holders in Manitoba

Pursuant to section 56 of the Controlled Drugs and Substances Act (CDSA), Medical Directors of Land System or Air Medical Response System licence holders authorized under The Emergency Medical Response and Stretcher Transportation Act (Manitoba) 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 (NCR) 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.

Medical Director means a person defined as a Medical Director under the Land Emergency Medical Response System Regulation (Manitoba) or Air Emergency Medical Response System Regulation (Manitoba), and who is ultimately responsible for ordering, transporting, storing and providing controlled substances to affected paramedics for a Land System or Air Medical Response System licence holder authorized under The Emergency Medical Response and Stretcher Transportation Act (Manitoba).

Paramedic means a person who is licensed by Manitoba Health under the Land Emergency Medical Response System Regulation (Manitoba) or Air Emergency Medical Response System Regulation (Manitoba) to practice paramedicine as a Technician-Paramedic, Technician-Advanced Paramedic or Aeromedical Attendant in Manitoba, and is authorized by a Medical Director 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 Medical Directors with the authority to possess, transport and provide controlled substances required by the paramedics employed by licensed Land or Air Medical Response System licence holders to which Medical Directors are affiliated.

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

1. Take necessary steps, in accordance with guidelines concerning controlled substances established by Manitoba Health, to ensure the security of controlled substances in storage and during transportation;
2. Order controlled substances from a hospital pharmacy in accordance with guidelines concerning controlled substances established by Manitoba Health;
3. Record all transactions involving controlled substances, i.e., date, name and quantity of controlled substances ordered, received, stored in ambulance or aircraft, and provided to paramedics (to be carried on their person);
4. Maintain all records with respect to controlled substances submitted by paramedics working for their Land System or Air Medical Response System licence holder;
5. Report all incidences of loss or theft of controlled substances in writing to Health Canada within 10 days of discovery; and
6. Keep information specified in (3) and (4) for at least two years and make it available to Health Canada upon request.

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

Diane Allan
Director, Office of Controlled Substances
Controlled Substances and Tobacco Directorate
Healthy Environments and Consumer Safety Branch

Effective Date: September 30, 2010