Factsheet: New Classes of Medical Practitioners Regulations

May 2012

News Release: Harper Government Supports Better Health Care by Allowing More Health Professionals to Prescribe Legal Controlled Substances

The Harper Government today proposed new regulations that aim to increase flexibility within the health care system and improve the timeliness of service delivery in Canada.

The proposed New Classes of Practitioners Regulations will allow other health professionals, namely nurse practitioners, midwivesand podiatrists to prescribe and administer selected drugs containing legal controlled substances when treating patients, if they are authorized to do so under provincial/territorial legislation. These health professionals are currently able to prescribe other medications, such as antibiotics, to their patients, but are currently prohibited from prescribing medications containing controlled substances such as codeine, fentanyl and diazepam.  Currently, only physicians, dentists and veterinarians are allowed to prescribe these medications under the Controlled Drugs and Substances Act (CDSA). 

In the case of dentists and veterinarians, the list of controlled substances they are able to prescribe is limited by their scope of practice, as defined by their respective provincial/territorial regulatory authorities.

Nurse Practitioners

Nurse practitioners are primary health professionals for many Canadians. Currently, even though some provincial and territorial governments have authorized nurse practitioners to prescribe medications containing controlled substances, the CDSA does not allow them to do so.  This disconnect means that patients who would otherwise access complete health care through a nurse practitioner now have to visit a physician in order to access the medication they need, or wait until the nurse practitioner consults a physician who can prescribe the required medication.  In this regard, the proposed NCPR would allow nurse practitioners to fully practice their profession by ordering, prescribing and administering medications containing controlled substances, with the following exclusions: heroin, cannabis, opium, coca and anabolic steroids (except testosterone).

Midwives

Midwives are specialists in normal childbirths, providing care through early pregnancy to birth and afterwards, to women and their infants. They may need to prescribe controlled substances to deal with pain during labour and after birth.  Currently, midwives lack the authority to prescribe medications containing controlled substances. This has resulted in patients suffering from unnecessary pain during labour because midwives must refer their patients to a physician in order for them to obtain a prescription for these types of medications. Improved access to selected controlled substances would alleviate this situation and result in more effective health care service delivery and improved quality of patient care. The following exclusion of controlled substances would apply to midwives: heroin, cannabis, opium, coca, methadone, buprenorphine, amphetamine, benzphetamine, methamphetamine, phenmetrazine, phendimetrazine and anabolic steroids. 

Podiatrists

Podiatrists are specialized in the diagnosis and treatment of illnesses and diseases affecting the foot, ankle and lower legs, and thus use medications containing controlled substances to sedate patients during foot surgery and in managing post-operative pain.  While doctors of podiatric medicine (a subset of podiatrists) can prescribe benzodiazepines in accordance with a Section 56 exemption issued under the CDSA, the proposed regulations would now allow all podiatrists to prescribe a broader range of medications in order to provide appropriate care to their patients.  This will result in more effective health care service delivery and improved patient comfort and well-being. The exclusions of controlled substances for this class of practitioner are: heroin, cannabis, opium, coca, methadone, buprenorphine, amphetamine, benzphetamine, methamphetamine, phenmetrazine, phendimetrazine and anabolic steroids.

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