Subsection 56(1) Class Exemption for Paramedics in Alberta

Pursuant to subsection 56(1) of the Controlled Drugs and Substances Act (CDSA) and the Precursor Control Regulations (PCR), advanced care paramedics of health care service providers in the province of Alberta 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 buprenorphine, fentanyl, hydromorphone, ketamine, morphine, oxycodone and pethidine
• Subsections 5(1) and 5(2) of the CDSA with respect to buprenorphine, diazepam, fentanyl, hydromorphone, ketamine, lorazepam, midazolam, morphine, oxycodone and pethidine
• Subsections 6(1), 6(2), 9(1) of the PCR for ephedrine

In respect of this exemption,

• Controlled substance means one of the following substances: buprenorphine, diazepam, ephedrine, fentanyl, hydromorphone, ketamine, lorazepam, midazolam, morphine, oxycodone and pethidine.
• Designated Administrator means a person who is in a managerial or medical director position and is ultimately responsible for ordering, transporting, storing and providing controlled substances for an ambulance operator licensed under the Alberta Emergency Health Services Act and the Ground Ambulance Regulation.
• Medical Director means a person, as defined in the Alberta Emergency Health Services Act and the Ground Ambulance Regulation, who is a physician designated to provide medical control to paramedics, and is in a managerial position with ultimate responsibility for ordering, transporting, storing and providing controlled substances for an ambulance operator licensed under the Alberta Emergency Health Services Act and the Ground Ambulance Regulation or an organization that provides emergency medical services in Alberta.
• Advanced Care Paramedic means a person who is registered under the Alberta Health Professions Act, Alberta Health Professions Restricted Activity Regulation, and the Paramedic Professions Regulation to practice as an Advanced Care Paramedic in that province and to administer controlled substances as part of the practice of paramedicine.
• Authorized Prescriber means a health care professional who is permitted by federal and provincial legislation, their regulatory college, Alberta Health Services, and practice setting (where applicable) to prescribe medications.
• 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 advanced care paramedics with the authority to possess, transport, administer, provide and destroy controlled substances when providing care to patients within their scope of practice as set out in the Alberta Health Professions Act, Alberta Health Professions Restricted Activity Regulations, and the Paramedics Professions Regulation and in accordance with relevant protocols established by the ambulance operator licensed under the Alberta Emergency Health Services Act and the Ground Ambulance Regulation or the organization that provides emergency medical services with which they are affiliated, and subject to the terms and conditions of this exemption.

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

1. Administer controlled substances in accordance with case-specific directions by an Authorized Prescriber, or pre-approved protocols;
2. Provide controlled substances as a bridge supply following a prescription by an Authorized Prescriber while working within the Mobile Integrated Healthcare service in the community;
3. Record all transactions involving controlled substances, i.e., date, name and quantity of controlled substances obtained, administered, provided and returned, and provide such a record to the Designated Administrator for record-keeping purposes;
4. Take necessary steps, in accordance with guidelines established by the ambulance operator licensed under the Alberta Emergency Health Services Act and the Ground Ambulance Regulation or the organization that provides emergency medical services with which they are affiliated, to ensure the security of the controlled substances on their person and in their emergency vehicle or aircraft;
5. Report immediately to 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;
6. Dispose of unserviceable controlled substances, or return unserviceable controlled substances to the Designated Administrator who supplied the controlled substances, or the pharmacy that provided the controlled substances to the Designated Administrator in accordance with guidelines established by the ambulance operator licensed under the Alberta Emergency Health Services Act and the Ground Ambulance Regulation or the organization that provides emergency medical services; and
7. Obtain controlled substances only from the Designated Administrator of the ambulance operator licensed under the Alberta Emergency Health Services Act and the Ground Ambulance Regulation or the organization that provides emergency medical services with which they are affiliated.

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.

This exemption may be suspended without prior notice if the Minister determines that such a suspension is necessary to protect public health or public safety.

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,

Original signed by

Carol Anne Chénard
A/Director General
Controlled Substances and Overdose Response Directorate
Health Canada

Effective Date: January 11, 2013

Date modified: 2024-02-02