Nurse Practitioner Practice and Controlled Substances in Ontario: Current Practice and Future Intent.

In 2012, the Canadian Government revised regulations under the Controlled Drugs and Substances Act to allow nurse practitioners (NPs) to prescribe controlled substances. In Ontario, it remains illegal for NPs to prescribe controlled substances, as provincial law prohibits this practice. In 2013, the College of Nurses of Ontario (CNO) conducted an online survey of NPs to inform future development of regulations and practice standards that would promote safe, ethical and effective practice when NPs are permitted to prescribe controlled substances in Ontario. The objectives of the survey were to better understand current NP practice with clients requiring controlled substances, NP learning needs related to controlled substances and their future intent to prescribe controlled substances if the authority to do so is introduced. A total of 1,447 Ontario NPs were invited via e-mail to complete the survey. The survey sample consisted of all NPs registered with CNO with an Adult ( n = 462) or a Pediatrics ( n = 204) Specialty Certificate and a random sample of NPs with a Primary Healthcare Specialty Certificate ( n = 781). A total of 529 NPs (37%) responded to the survey. The majority of respondents (71%) reported that they would prescribe controlled substances if they were given the legal authority. This was more prominent for NPs working in specialized practice (79%) compared with those working in generalist practice (66%). Most NPs (64%) indicated they would require additional education to gain the competence to prescribe controlled substances. The most common educational needs identified were related to pharmacotherapy, jurisprudence and the knowledge to assess and manage the unique risks associated with controlled substances, such as addiction, diversion and misuse. As NP authority to prescribe controlled substances is implemented across Canada, these survey results may help inform regulatory bodies, educators, employers and NPs in establishing mechanisms and policies to support safe, ethical and effective client care.