New Canadian Regulations Would Dramatically Expand Prescribing Authority

Canada has moved one step closer to allowing nurse practitioners, midwives and podiatrists to prescribe some medications authorized by Health Canada, potentially changing how millions of Canadians obtain their medications.

Under proposed new regulations announced by Canadian Health Minister Leona Aglukkaq on 13 May, parts of the Controlled Drugs and Substances Act would be re-interpreted to expand the number of authorities allowed to prescribe legal controlled substances. Under current law, only doctors, dentists and veterinarians may prescribe, administer or provide medicinal substances to patients.

The proposed New Classes of Practitioners Regulations (NCPR) would expand prescribing authority to additional groups in order to "improve flexibility within the health care system and the timeliness of service delivery in Canada," said Aglukkaq.

"Because of these new regulations, nurse practitioners will be able to efficiently deliver a more comprehensive level of quality care for which they are trained," said Judith Shamian, President, Canadian Nurses Association.

While the prescribing authority will not be without limits-particularly for midwives-the move has been called "an important first step which we hope will ultimately facilitate" additional authority, said Kris Robinson of the Canadian Midwifery Regulators Consortium.

Nurse practitioners will be far less limited in their prescribing authority, and will only be unable to prescribe heroin, cannabis, opium, coca and most anabolic steroids.

The regulations have also been under consideration in the US to some degree of controversy. Aglukkaq's move to implement similar regulations in Canada could prove to be a case study for US-based health policy analysts hoping to understand the effect of nurse practitioners' prescribing authority on the healthcare delivery system.

Comments on the proposal are due to Health Canada within 30 days of the regulation's publication in the Canada Gazette.

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