Health Canada exemption has been beneficial in N.S., says College of Pharmacists CEO

A Health Canada exemption that allows pharmacists wider authority to extend and renew prescriptions has made a marked improvement to Nova Scotia's health-care system, says the CEO of the Nova Scotia College of Pharmacists.

Beverley Zwicker says the ability for pharmacists to prescribe a broader range of drugs has taken some of the health-care burden from doctors and nurse practitioners.

The exemption to the Controlled Drugs and Substances Act, which extends until 2026, came into effect during the COVID-19 pandemic.

"Pharmacists have six years of education as healthcare professionals, providing them with essential skills and knowledge that could be more effectively incorporated into our healthcare system," Zwicker said.

"There is a significant opportunity to enhance the utilization of pharmacy professionals' knowledge and expertise, and we are actively doing that here in Nova Scotia."

The exemption authorizes pharmacists to extend and renew prescriptions and transfer prescriptions to other pharmacists. 

Giving pharmacists more responsibility 

The exemption also authorizes physicians and practitioners to verbally prescribe medications containing controlled substances over the phone and allows pharmacists to deliver medications to a patient's home.

These were responsibilities pharmacists did not have prior to the pandemic.

Some of the controlled substances include benzodiazepines to treat anxiety and depression, and medication that treats opioid use disorders that include methadone and buprenorphine. 

Zwicker has urged the federal government to make the exemption permanent in Nova Scotia. 

"The provisions they made worked well," Zwicker said. "But there's more that should be done at the national level so that the federal government gives full autonomy for the provinces." 

In a written statement provided to CBC, Health Canada says it will consider all viewpoints in its review of the exemption.

"As Health Canada moves forward with developing final regulations, all stakeholder feedback received will be taken into consideration," Health Canada said in a statement to CBC.

A study by a team of scientists from Dalhousie University and Nova Scotia Health was published in August that shows an increase in the number of prescriptions dispensed between 2021 and 2022. 

The study found that pharmacists prescribed more opioid therapies in rural Nova Scotia in the two years after the exemption came into effect. There is also an overall increase across the province in residents seeking opioid therapies like methadone and buprenorphine. 

Chiranjeev Sanyal, co-author of the study, said patients living in rural areas no longer had to go to more urban areas to have their needs met.

"They had an alternative … they can access their meds by reaching out to their nearest pharmacies."

'Evidence-based care is a really important intervention and solution'

Toronto physician Abhimanyu Sud says greater access to opioid therapies is important for opioid harm reduction. 

"People have been calling for greater pharmacists' involvement to facilitate greater community access to opiate addiction care," said Sud.

"We are living in a time of … crisis of opioid-related harm in this country and drug-related harm to this country, of which increasing access to evidence-based care is a really important intervention and solution."

Zwicker also chairs the National Association of Pharmacy Regulatory Authorities. She said the association hopes to meet with the federal deputy health minister to reiterate its position that the exemption is helping the health-care system.