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