February 2016

Are you prescribing illegally?

The College has received reports from Ontario’s Narcotics Monitoring System (NMS) showing that some NPs are prescribing controlled substances, which is illegal.

After meeting with NPs, making practice inquiries and conducting investigations, the College learned that there are several reasons why NPs might be identified on the NMS as prescribers of a controlled substance.

Use the questions below to reflect on your practice and identify what changes you may need to make:

Are you intentionally prescribing controlled substances?
It is illegal for Ontario NPs to prescribe controlled substances. If you knowingly prescribe a controlled substance because you feel it is in the client’s best interest, you need to develop other strategies to meet the client’s needs while practising according Ontario legislation and the College’s standards. Refer clients to an appropriate health professional, such as a physician, when their needs are beyond the legal scope of NP practice.

Do you recognize controlled substances?
You may be prescribing a medication that you don’t know is a controlled substance. You are accountable for always verifying whether a medication is a controlled substance before writing a prescription.

Is your practice creating confusion about who is the prescriber?
You may appear on the NMS report because it is unclear who is prescribing the controlled substance. For example, you may be asking a physician to co-sign prescriptions you have written, or your workplace may have an electronic health record system that automatically adds your contact information to prescriptions. You are accountable for looking at your practice and workplace systems and working with your employer to eliminate any risk that you could be seen as prescribing controlled substances.

Do you understand what is considered “prescribing”?
You may be unaware that renewing a prescription for a controlled substance, or prescribing a tapering dose to gradually discontinue a controlled substance, is considered to be prescribing.        

For help determining whether a drug is a controlled substance, visit www.cno.org/drug-and-tests-lists.

To help you apply the College’s standards when caring for clients who may require controlled substances, click here.

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