Supplementary information: Subsection 56(1) exemptions
- Supplementary Information: Subsection 56(1) Exemption for Nurses who Provide Health Care at a Community Health Facility
- Supplementary Information: Subsection 56(1) Exemption for the Person in Charge of a Hospital and/or Pharmacist who Supplies Controlled Substances to a Community Health Facility
Nurses are often responsible for providing health care services in various types of communities across Canada. Within this context, these nurses routinely conduct activities (i.e., possess, deliver, administer, transport) with controlled substances (e.g., narcotics, benzodiazepines) when treating a variety of health conditions and/or dealing with emergency situations such as trauma.
Under the Controlled Drugs and Substances Act (CDSA) and its regulations, nurses can only conduct activities with controlled substances when they are working in a hospital setting and pursuant to a prescription/order from a practitioner (e.g., doctor of medicine, dentist). As some community health facilities may not meet the definition of a hospital, nurses working in these facilities require further authorization under the CDSA and its regulations to conduct certain activities with controlled substances.
In addition, hospitals may only supply controlled substances under certain circumstances, such as in an emergency situation. In some cases, hospitals and community pharmacies may need to supply community health facilities, particularly in remote and/or isolated communities with controlled substances on a regular basis; therefore, authorization is required to allow this activity.
In order for nurses, hospitals and community pharmacies to conduct these activities, Health Canada has issued two exemptions under subsection 56(1)Footnote 1 of the CDSA that will authorize:
- Nurses who provide health care services at a community health facility to conduct certain activities with controlled substances; and,
- Persons in Charge of a hospital and pharmacists to supply controlled substances to a community health facility.
The two subsection 56(1) exemptions are legal documents. As these documents exempt nurses, pharmacists and the Person in Charge of a hospital from provisions of the CDSA and its regulations, certain terms and conditions are included to set out the requirements which need to be met. These terms and conditions are similar to the provisions that are included in the regulations for health professionals (i.e. pharmacists, practitioners, nurse practitioners and hospitals).
In particular, the exemption for nurses provides them with the authority to possess, sell, provide, administer, transport, send and deliver controlled substances while providing health care services at community health facilities under certain conditions. These conditions pertain mainly to record keeping for all activities conducted with the controlled substances, keeping controlled substances secure when storing, receiving and returning as well as reporting to Health Canada of any loss or theft of controlled substances. See contact information section for website address for access to the loss or theft form.
The exemption also specifies that nurses must follow any policies or procedures developed by the health care service provider in order to support the proper conduct of activities with controlled substances at a community health facility. If there are no policies or procedures in place at the community health facility regarding controlled substances, Health Canada encourages that these be developed.
The terms and conditions set out in the attached exemptions will be reviewed as the exemptions are implemented and amended as necessary. The exemptions will remain in effect until they are revoked or replaced.
Reporting and Contact Information
An online Loss or Theft Report form can be found at the following: http://www.hc-sc.gc.ca/hc-ps/substancontrol/substan/compli-conform/loss-perte/loss_rep-rap_perte-eng.php
Loss and theft reports of controlled substances by nurses and the person in charge of a hospital may be sent to:
Compliance and Monitoring Division
Office of Controlled Substances
161 Goldenrod Driveway AL 0300B
Ottawa ON K1A 0K9
Toll Free: 1-866-569-2560
Questions on the issuance of these exemptions may be directed to:
Office of Controlled Substances
Opioid Response Branch
- Footnote 1
Subsection 56(1) of the CDSA allows the Minister of Health to exempt any person or class of persons or any controlled substance or precursor or class thereof from the application of all or any provisions of the Act or the regulations if, in the opinion of the Minister, the exemption is necessary for a medical or scientific purpose or is otherwise in the public interest.
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