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Related Experiment Video

Updated: Apr 29, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Nurse practitioners and controlled substances prescriptive authority: improving access to care.

Michelle A Ambrose1, Denise S Tarlier2

  • 1Michelle A. Ambrose, BN, RN, University of Northern British Columbia, Prince George, BC.

Nursing Leadership (Toronto, Ont.)
|May 28, 2014
PubMed
Summary

Nurse practitioners (NPs) in Canada can now prescribe controlled substances, enhancing primary care access and advancing the NP role. This regulatory change, inspired by US experiences, aims to improve healthcare delivery and professional autonomy for NPs.

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Area of Science:

  • Health Policy
  • Nursing Practice
  • Pharmacology

Background:

  • Health Canada introduced the New Classes of Practitioners Regulations (NCPR) in 2012, granting prescriptive authority for controlled substances to nurse practitioners (NPs), midwives, and podiatrists.
  • This regulatory shift aims to improve flexibility and timeliness in primary care delivery by enabling NPs to prescribe controlled medications.
  • Previous studies in the United States indicate that expanded NP prescriptive authority for controlled substances has led to improved primary care access, reduced healthcare costs, and professional role advancement.

Purpose of the Study:

  • To examine the impact of nurse practitioners' (NPs) prescriptive authority for controlled substances on primary care access.
  • To analyze the influence of prescriptive authority for controlled substances on nurse practitioner (NP) role development.
  • To provide insights into anticipated practice changes for Canadian NPs based on US experiences with similar regulatory expansions.

Main Methods:

  • Qualitative examination of key issues identified from US nurse practitioner (NP) experiences.
  • Analysis of practice changes anticipated for Canadian NPs following the implementation of the NCPR.
  • Review of literature on the effects of expanded prescriptive authority on primary care access, professional autonomy, and prescriber knowledge.

Main Results:

  • US studies suggest expanded NP prescriptive authority improves access to primary care services.
  • The evolution of the NP role and increased professional autonomy are positive outcomes observed in the US.
  • Key issues influencing practice changes include access to care, professional autonomy, and prescriber knowledge.

Conclusions:

  • The expansion of prescriptive authority for controlled substances presents opportunities for enhanced NP roles in Canada.
  • Addressing issues of access to care, professional autonomy, and prescriber knowledge is crucial for successful implementation.
  • Recommendations are provided for nurse leaders and educators to support NPs in their expanded role responsibilities.