Transportation of Controlled Substances in Canada

Background

As health professionals look for the best way to meet the needs of their patients, there are more models being conceived. In order to provide guidance on the establishment of these new models, Health Canada has developed the following policy position on providing medications that are regulated under the Narcotic Control Regulations (NCR), Part G of the Food and Drug Regulations (FDR), and the Benzodiazepine and Other Targeted Substances Regulations (BOTSR) to patients.

Scope

The following applies to patient specific medications (narcotics, controlled drugs, and targeted substances) provided to patients in the community, at locations including community based clinics, health centres or supervised consumption sites. As noted above, the following represents Health Canada's policy position. It does not constitute legal advice as to the scope of the Controlled Drugs and Substances Act (CDSA) and its regulations.

For the purposes of this document, the term practitioner refers medical doctors, veterinarians, dentists, and in some cases, nurse practitioners, podiatrists and midwives^{Footnote 1}.

This policy does not include cannabis for medical purposes.

Transportation

Pharmacists

The NCR, Part G of the FDR, and the BOTSR contain authorities permitting pharmacists to provide controlled substances to a person from whom the pharmacist has received a written prescription signed and dated by a practitioner. This includes the pharmacist transporting the controlled substances to the person. The controlled substances should be packaged in the pharmacy and dispensed with appropriate labelling. All other applicable regulatory requirements must also be met.

Practitioners

A practitioner can provide controlled substances to a person whom is under their professional treatment if the medication is required for the condition being treated. This includes the practitioner transporting the controlled substance to the patient. There are specific record keeping requirements for practitioners who do this (s54 of NCR; s60 of BOTSR; G.04.002 of FDR). All other applicable regulatory requirements must also be met.

1. For greater clarity, this includes those nurse practitioners who are permitted to prescribe or possess controlled substances, or to conduct an activity with it, in accordance with the New Classes of Practitioners Regulations.

Employee of a hospital

A hospital employee who is authorized by the person in charge of the hospital can provide controlled substances to a person pursuant to a prescription (or hospital written order) if the person is under treatment of the hospital as an in/out patient. This includes the hospital employee transporting the medication to an out-patient of the hospital.

For these purposes, Health Canada recommends that the hospital employee be a person with appropriate knowledge of the laws and regulations that govern controlled substances as well as the proper handling of patient medications.

Pursuant to the regulations under the CDSA, provinces and territories have a role in defining what facilities are designated a hospital in their jurisdictions.

Nurses

Under the CDSA and its regulations, nurses, other than nurse practitioners, can only conduct activities with controlled substances if they have been prescribed by a practitioner and they are employees of a hospital. Health Canada recognized that nurses are often responsible for primary care in the community; and therefore within this context nurses often conduct activities with controlled substances.

To this end, Health Canada issued two s56(1) exemptions on September 5, 2018 to authorize nurses to possess, provide, administer, transport, send and deliver controlled substances while providing health care services at community health facilities under certain conditions. Please refer to the exemptions for more details. In addition to the activities above, the exemption allows nurses working at community health facilities to transport and provide controlled substances, prescribed by a practitioner, to the patient.

Additional Requirements

Please note that there may be additional federal, provincial and municipal laws and regulations that must be complied with in addition to those under the CDSA.

For any questions, please do not hesitate to contact: csd.regulatory.policy-politique.reglementaire.dsc@hc-sc.gc.ca.