Controlled Substances and Pharmacy Practice
Pharmacists play an important role in supporting the safe and effective use of controlled substances and in helping maintain continuity of care for patients.
New Controlled Substances Regulations
On October 1, 2026, Health Canada’s new Controlled Substances Regulations (CSR) will come into force, replacing multiple existing federal regulations and incorporating key temporary exemptions into a single, modernized framework.
The subsection 56(1) class exemption introduced during the COVID-19 pandemic will end on September 30, 2026. The CSR will permanently establish several authorities pharmacists have exercised under the exemption, while also introducing new authorities and changes intended to better reflect current pharmacy practice.
- Health Canada Info Sessions: Health Canada is offering information sessions on the changes affecting community pharmacy under the new CSR, specifically for pharmacists, pharmacy technicians and pharmacy managers. View session dates and register.
- Health Canada Guidance Document: Controlled substances guidance for community pharmacists and pharmacy technicians
Key changes as of October 1, 2026
- Extend, renew and transfer prescriptions: Pharmacists will continue to be able to extend, renew and transfer prescriptions for controlled substances within two years of the date the prescription was received, subject to CSR requirements.
- Therapeutic substitution: Pharmacists will be authorized to substitute one controlled substance for another, where permitted under provincial or territorial scope of practice.
- Adapt prescriptions: Pharmacists will continue to be able to adapt controlled substance prescriptions within two years of the date the prescription was received, including deprescribing and part-filling.
- Expanded pharmacy technician authorities: Pharmacy technicians will be authorized to independently perform additional activities involving controlled substances, where permitted under provincial or territorial requirements.
- Central fill: Controlled substance prescriptions can be filled through central fill models without requiring a dealer’s licence.
Related federal authority: Administration of controlled substances
- Under a separate subsection 56(1) class exemption effective April 1, 2026, pharmacists practising outside hospitals can administer prescribed controlled substances where permitted within their provincial or territorial scope of practice.
What pharmacists can do across Canada
The CSR establish what is permitted under federal law, while pharmacists’ scope of practice is established at the provincial and territorial level. As a result, the authorities pharmacists can exercise in practice vary across Canada.
The chart below provides an overview of how pharmacists are authorized to manage prescriptions for controlled substances in each province and territory.
Download a PDF of this chart.
CPhA advocacy: From exemptions to the CSR
CPhA has long advocated for federal controlled substances rules that reflect current pharmacy practice and support continuity of care. During the COVID-19 pandemic, we advocated for the subsection 56(1) exemption, its extension and for key authorities under the exemption to become permanent, while also developing practice tools and resources to help pharmacists navigate the temporary framework.
In 2024, CPhA participated in Health Canada’s consultation on the proposed Controlled Substances Regulations, supporting modernization while calling for further changes, including therapeutic substitution and pharmacist-initiated prescribing where authorized provincially or territorially.
The final CSR represent important progress, including making key temporary authorities permanent and enabling therapeutic substitution. CPhA continues to engage with Health Canada as the new regulations are implemented.
Progress, with more work ahead: The new CSR are an important step forward, but CPhA continues to advocate for pharmacists to be recognized as practitioners under the Controlled Drugs and Substances Act, enabling pharmacist-initiated prescribing where authorized provincially or territorially and supported by appropriate safeguards.
Navigating new authorities
Controlled substances authorities across Canada
See our updated chart for an overview of how key pharmacist authorities related to controlled substances are enabled across Canada.
Check your provincial or territorial requirements
Implementation of the CSR will vary based on provincial and territorial legislation, regulations and standards of practice. Pharmacy professionals should consult their provincial or territorial pharmacy regulatory authority to understand which authorities apply in their jurisdiction.
Health Canada resources
- Information sessions: Health Canada is offering information sessions on the changes taking effect under the new CSR.
- Controlled Substances Regulations: Review the final regulations and Regulatory Impact Analysis Statement in the Canada Gazette, Part II.
- Subsection 56(1) class exemption: The current subsection 56(1) class exemption remains in effect until September 30, 2026.
- Implementation guide: Controlled substances guidance for community pharmacists and pharmacy technicians