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FAQs

Answering your questions about prescribing controlled drugs and substances
​​Have a question about prescribing controlled drugs and substances? Email us at practice@crnbc.ca.

 Education requirements

What mandatory courses do I have to take?

​NPs who want to prescribe CDS need to take one of three specified CDS prescribing courses. These courses and other requirements are outlined in the Scope of Practice for NPs (pages 26-27).

NPs will also need to complete the CRNBC CDS prescribing learning module. ​

In addition, NPs wanting to prescribe for clients with chronic non-cancer pain require additional education.

NPs wanting to continuation prescribe medications for opioid substitution therapy must complete additional education. See the Standards, Limits and Conditions for Opioid Agonist Treatment Prescribing for Opioid Use Disorder, beginning on p. 30 of the NP Scope of Practice document.  

What's included in the CRNBC CDS Prescribing learning module?
The module complements the required CDS Prescribing course. It focuses on provincial and other relevant legislation and requirements such as the CRNBC Standards, Limits and Conditions for CDS Prescribing and Controlled Prescription Program. It includes information about the risks and best mitigation strategies associated with prescribing CDS, links to useful resources and reflective learning activities.
Do I need to send my certificate to CRNBC when I complete my CDS prescribing course?
No, you don't need to send your certificate to CRNBC. However, we recommend that you retain your certificate as a record of your professional development.

 Standards, limits and conditions

Are NPs able to prescribe all narcotics and controlled substances?

Federal legislation excludes some drugs, such as coca and opium, from NP prescribing authority. Federal legislation limits other drugs such as amphetamine, benzphetamine, methamphetamine, phenmetrazine, and phendimetrazine, to the treatment of specific situation that require initial diagnosis and treatment by a medical specialist.

The CRNBC prescribing standards, limits and conditions, limit other drugs or restrict them to ‘continuation prescribing’. These include:

  • archaic drugs where safer alternatives exist (e.g., barbiturates, meperidine)
  • drugs used to treat a disease or disorder that requires initial diagnosis and treatment by a medical specialist, e.g., methylphenidate, dextroamphetamine
  • drugs considered particularly high risk, e.g., ketamine hydrochloride, sodium oxybate)
Can NPs prescribe synthetic cannabinoids, e.g., Nabilone ®?

NPs in BC are not allowed to prescribe synthetic cannabinoids at this time. See CRNBC limits in the NP prescribing standards (beginning on page 26). For more information on this or other scope of practice matters, contact practice@crnbc.ca.

Can NPs issue a medical document for clients to get medical marijuana?

​No. NPs are not allowed to issue these medical documents in BC. Federal laws have changed to allow individuals to legally possess dried leaf marijuana if it was obtained, under the Access to Cannabis for Medical Purposes regulation from a licensed producer, with a supporting medical document from an authorized health care practitioner (either a physician or nurse practitioner). However, these changes for NPs have not been adopted by the provincial government in BC and are not included in the scope of practice of NPs at this time.​

Refer to Legislation Relevant to Nurses' Practice for more information about medical cannabis.

Can NPs prescribe opioid agonist therapies?

As of Feb. 14, 2018, prescribing opioid agonist treatment (OAT) for opioid use disorder is within the scope of nurse practitioners (NPs).

Before prescribing opioid agonist treatment for opioid use disorder, NPs must complete the requirements for:
  • Controlled Drugs and Substances Prescribing as set out in Part 2, Section C,  Scope of Practice for Nurse Practitioners (p; and
  • Opioid Agonist Treatment Prescribing for Opioid Use Disorder as set out in Part 2, Section D, Scope of Practice for Nurse Practitioners

The standards, limits and conditions for OAT set out the requirements for both induction and continuation/maintenance prescribing of opioid agonist treatment for opioid use disorder. These standards, limits and conditions do not apply to prescribing opioid agonists for pain and other symptoms.

How will NP narcotic prescribing be monitored?

CRNBC's QA Committee oversees CRNBC's prescription review program, which includes monitoring and reviewing NP prescribing to identify trends and issues. This includes review of PharmaNet data, for instance, when assessing registrant applications for Health Canada section 56 exemptions (for prescribing methadone maintenance therapy) and CPP prescription pads. Registrant good standing is also confirmed.

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