Opioids prescribed by pharmacist under the Health Canada's Controlled Drugs and Substances Act temporary exemption

During the coronavirus disease 2019 (COVID-19) pandemic, Health Canada issued a temporary exemption for the Controlled Drugs and Substances Act (CDSA). Very little is known about pharmacists prescribing opioids under the CDSA temporary exemption.

This study aimed to evaluate the impact of CDSA subsection 56(1) temporary exemption on prescribing of opioids by direct patient care pharmacists during COVID-19 between February 1, 2018, and April 30, 2022.

Descriptive statistics (sample mean, sample SD, sample proportion) and data visualization tools were used to explore the possible changes owing to CDSA. In the first stage, a linear regression model was fit to the data to detect the changes. Second, the time dependence of the data was checked by examining the autocorrelation plots and testing the dependence of the residuals, and then a suitable time series process was used.

The mean overall pharmacist-prescribed opioid weekly claims increased from 0.0 (per-CDSA policy period) to 57.0 (post-CDSA policy period). The time series regression for the mean-level change for the overall prescription data was 36.29 (95% CI 27.14-48.52, P < 0.0001). The time series regression for the mean-level change for the analgesic prescription data and the opioid use disorder prescription data was 28.95 (95% CI 20.88-40.13, P < 0.0001) and 6.74 (95% CI 5.80-7.82, P < 0.0001).

The temporary exemption under the CDSA during the COVID-19 pandemic allowed pharmacists in Nova Scotia to prescribe opioids, ensuring continuity of opioid therapy for adults. Future studies are needed to investigate the reasons behind the low uptake of CDSA exemptions by pharmacists involved in direct patient care.