On November 1, 2012, the federal government enacted the New
Classes of Practitioners Regulations (“NCPR”) under the Controlled Drugs and Substances Act (“CDSA”).
The CDSA authorizes medical doctors, dentists and veterinarians
to prescribe, administer and possess narcotics and other controlled substances
when treating patients. The NCPR has
expanded this authority to three new classes of practitioners: midwives, nurse
practitioners and podiatrists/chiropodists.
These practitioners are now permitted under federal law to
prescribe, administer and provide to their patients certain “listed substances”
– i.e. substances set out in Schedule 1 to the Benzodiazepines and Other Targeted Substances Regulations, the Controlled
Drugs schedule of the Food and Drug
Regulations (Part G), and the schedule to the Narcotic Control Regulations, as well as anything that contains
This regulatory change addresses a disconnect between the
CDSA and the authorities granted to midwives, nurse practitioners and
podiatrists/chiropodists at the provincial level to prescribe and administer
medications to their patients. Health professionals are regulated at the provincial/territorial level.
Depending upon the jurisdiction, midwives, nurses and
chiropodists/podiatrists may be authorized to prescribe and/or administer certain
narcotics and other controlled substances consistent with their provincially-legislated
scope of practice. Previously the
restrictions imposed by the CDSA prevented them from doing so.
The practical result of this inconsistency was that midwives,
nurse practitioners and podiatrists/chiropodists needed to refer their patients
to or consult with a physician in order for the patient to obtain a
prescription for narcotics and other controlled substance. This created
inefficiencies in the provision of health care to patients.
With the NCPR in place, midwives, nurse practitioners and
chiropodists/podiatrists are now permitted to prescribe and
administer a number of controlled substances, so long as the activities are authorized
under their provincially-legislated scopes of practice.
The implications of the NCPR for health practitioners and
patient care will depend on the province/territory in which the care is
provided and the practitioners’ scope of practice. Generally speaking, the amendments:
- Allow midwives, nurse practitioners and chiropodists/podiatrists to better exploit their provincially-legislated scopes of practice.
- Enable the skills and abilities of these practitioners to be better and more efficiently used to benefit patients.
- Eliminate the need for midwives, nurse practitioners and podiatrists/chiropodists to refer their patients to a physician in order for the patient to access their medications; and
- Enable patients to obtain their medications in a more timely and efficient manner.
A copy of the NCPR and more information about the amendments
is available at: http://gazette.gc.ca/rp-pr/p2/2012/2012-11-21/html/sor-dors230-eng.html
The author would like to thank Karen Phung, Articling
Student, for her assistance with this article.