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Prescribing Opioids and Other Controlled Drugs and Substances

PrescribeIT® can be an important tool for prescribing opioids and other controlled drugs and substances, as it:

  • Supports secure clinical communications with pharmacists
  • Allows you to cancel prescriptions if they are not needed
  • Allows you to monitor the dispense status of these medications
  • Ensures the secure transmission of prescriptions from the prescriber to pharmacy
  • Reduces the opportunity for forgeries, altered prescriptions and other fraudulent use

However, dependent on the Province or Territory (Jurisdiction), there may be limitations when electronically prescribing opioids and other controlled drugs and substances as determined by jurisdictional regulation and/or legislation. These are summarized below for the Provinces and Territories currently live with PrescribeIT®.  Note:  The information shared below does not include professional practice limitations.  Each clinician is responsible to meet the standards set by their regulatory college and other regulatory bodies when determining whether they are authorized to prescribe Opioids and Controlled Substances.

In addition to the below jurisdictional limitations, for prescribers using EMRs other than PS Suite, Ava, and Med Access (which have completed validation) the PrescribeIT® team may need to do some initial validation work with you prior to prescribing methadone. Contact your EMR Vendor or PrescribeIT® lead if you have further questions.

Jurisdiction

Considerations / Limitations

Alberta

  • After June 30, 2025, The TPP Program will only allow prescriptions for Type 1 monitored medications to be sent electronically via PrescribeIT®, if the sending EMR system has completed development to make the ‘Indication for Use’ mandatory for these prescriptions.  A list of conformed and approved EMR systems is available on the TPP website at https://www.tppalberta.ca/resources by selecting “Access a list of facilities and programs exempt from the use of TPP forms”.

    Using these conformed systems, prescriptions for Type 1 Medications can be sent electronically directly to a selected PrescribeIT®-enabled pharmacy of the patient’s choice, the TPP secure prescription form is NOT required, and the electronic prescription serves as the authoritative copy.
    • Prescribers are to complete the electronic prescription in PrescribeIT® including the same mandatory information as otherwise required on the TPP secure form, as outlined in the TPP program guide.
    • PrescribeIT® cannot be used for extemporaneously compounded prescriptions containing a Type 1 TPP-monitored ingredient.  These still require the TPP secure prescription form.
  • For TPP Type 1 medications, if the prescription is unable to be sent electronically via PrescribeIT® the TPP secure form is still required and the prescription should be processed in the EMR as otherwise done.
    • A printed PrescribeIT® prescription with barcode should NOT be given to the patient.
    • The patient must continue to have choice in the pharmacy at which their prescriptions are filled (i.e. patients must not be directed to only PrescribeIT®-enabled pharmacies)
    • Pharmacies should ensure that all prescriptions for TPP Type 1 medications received through PrescribeIT® include an ‘indication for use’ to meet the TPP Program requirements.  They should not accept prescriptions through PrescribeIT® for extemporaneously compounded prescriptions containing a Type 1 TPP-monitored ingredient, as these still require the TPP secure prescription form.

    Saskatchewan
    • There are no regulatory restrictions in Saskatchewan that affect the use of PrescribeIT® for electronically prescribing controlled/monitored drugs.
     
    • There are no regulatory restrictions in Manitoba that affect the use of PrescribeIT® for electronically prescribing controlled/monitored drugs.

    Ontario
    • There are no regulatory restrictions in Ontario that affect the use of PrescribeIT® for electronically prescribing controlled/monitored drugs.

    Quebec
    • There are no regulatory restrictions in Quebec that affect the use of PrescribeIT® for electronically prescribing controlled/monitored .

    New Brunswick
    • There are no regulatory restrictions in New Brunswick that affect the use of PrescribeIT® for electronically prescribing controlled/monitored drugs.

    PEI

    • There are no regulatory restrictions in PEI that affect the use of PrescribeIT® for electronically prescribing controlled/monitored drugs.

    Newfoundland & Labrador
    • For any medication found in the Schedule of Drugs under the Tamper Resistant Prescription Pad Program (TRPP)  the required TRPP form must be completed.  Do not create an electronic prescription in PrescribeIT®. 
    • Currently, the only acceptable method of transmission through PrescribeIT® for medications found in the Schedule of Drugs under the TRPP is for the form to be completed, scanned, and attached to a clinical communications message that is sent to the desired PrescribeIT® enabled pharmacy.