Health Canada’s new Controlled Substances Regulations (SOR/2025-242) came into force on October 1, 2026. They put the federal rules for narcotics, controlled drugs, benzodiazepines and other targeted substances into one set of regulations.
For most community pharmacies, day to day practice will not change much. The authorities pharmacists have used since 2020 under a temporary Health Canada exemption are now permanent. But a few new federal permissions do not apply in every province, and several colleges are still updating their standards. Here is what changed and where each province stands.
What the new regulations replace
The Controlled Substances Regulations (CSR) replace:
- the Narcotic Control Regulations;
- the Benzodiazepines and Other Targeted Substances Regulations;
- Parts G and J of the Food and Drug Regulations.
The section 56(1) class exemption that let pharmacists extend, transfer and accept verbal prescriptions for controlled substances expired on September 30, 2026. The CSR started the next day so there would be no gap.
What changed for pharmacists
Verbal prescriptions. Pharmacists and pharmacy technicians can accept a verbal prescription directly from a practitioner and must record it.
Extensions. A pharmacist can extend a prescription as long as the new expiry date is no later than two years after the day the pharmacist received it (section 101).
Transfers. A pharmacist or technician can transfer a prescription within two years after it was received (section 102). The federal rules limit the time period, not the number of transfers.
Prescriptions received before October 1. Health Canada’s guidance says it will allow these to be extended or transferred until October 1, 2028, subject to provincial rules.
Therapeutic substitution. A pharmacist may substitute one controlled substance for another, but only “if the pharmacist is authorized to do so under the laws of the province” (section 100). It applies to prescriptions only, not to orders.
Adapting and part fills. Changes to dose, form or regimen, and part fills, are allowed federally as long as the total dispensed does not exceed the quantity originally prescribed. Your province must also allow it.
Pharmacy to pharmacy sales. Emergency sales between pharmacists continue. A new rule also allows non emergency sales on a signed written order, but only to fill a prescription received at the other pharmacy or when the selling pharmacy is closing (section 93). This is what lets central fill work without a dealer’s licence.
Destruction. Pharmacists and technicians can destroy expired stock and patient returns at the pharmacy without prior Health Canada approval. One witness is needed: a pharmacist, technician, intern, practitioner or other health professional (section 110).
Loss and theft. A written report must go to Health Canada within 10 days after the pharmacist becomes aware of a loss or theft (section 109). Staff must tell the pharmacist immediately.
Records. Records, prescriptions and declarations must be kept for at least two years (section 123). Provinces can require longer.
Practitioners. Nurse practitioners, midwives and podiatrists are recognized as practitioners in the CSR itself, within the limits of their provincial scope.
What pharmacy technicians can do federally
Under the CSR, technicians can accept verbal prescriptions, transfer and receive transfers, receive stock, accept patient returns, deliver, and destroy or witness destruction.
They still cannot sell or provide a controlled substance to a patient, and ordering stays with the pharmacist. Health Canada’s guidance also says a pharmacist must be on site while controlled substance activities are taking place. Each province decides how much of this its technicians can actually do.
The provinces: what each college has said
The CSR sets the federal ceiling. Provincial law and college standards still decide what pharmacists and technicians can do in practice. Here is where each regulator stood as of October 7, 2026.
| Province or territory | Therapeutic substitution of controlled substances | Notable provincial limits |
|---|---|---|
| British Columbia | Not permitted | Only a pharmacist signs purchase and receipt records. Technician delivery must be delegated. Extensions limited to continuity of care. |
| Alberta | Permitted when authorized by Alberta law and ACP standards | ACP is updating its standards. Until then, follow the CSR. |
| Saskatchewan | Not addressed yet | Prescription Review Program drugs can be transferred only once. Verbal orders are a last resort. |
| Manitoba | Not permitted (provincial rules not yet in force) | M3P drugs excluded from continued care, and from verbal orders outside hospitals and personal care homes. Technicians cannot transfer. |
| Ontario | Not permitted | Adaptation allowed. Renewals capped at the lesser of the original quantity or a 12 month supply. |
| Quebec | Permitted for pharmacists | Federal technician authorities do not apply. Deliveries go directly to the patient. |
| New Brunswick | Permitted, as pharmacist prescribing under NB law | Prescriptions can be filled or refilled for one year from the issue date. |
| Nova Scotia | Not stated | Waiting on Health Canada clarification. |
| Prince Edward Island | Not permitted | No adaptation of controlled substances until provincial regulations change. |
| Newfoundland and Labrador | Not stated by the college | Bill 19 (passed June 2026) allows telephone prescriptions and pharmacy transfers without a tamper resistant pad. |
| Yukon, NWT, Nunavut | No guidance published | Check with the territorial licensing office. |
A few details worth knowing.
British Columbia. The College of Pharmacists of BC says “stricter provincial limits supersede broader federal permissions.” Extensions and renewals are allowed only for continuity of care. Technicians can receive shipments, but a pharmacist must sign the purchase and receipt records. The October 2026 PharmaCare Newsletter confirms the change but has no new PharmaCare policy.
Alberta. The Alberta College of Pharmacy says the federal limits in Standard 8.1.2(b)(i) no longer apply. It also says the CSR does not let pharmacists prescribe a controlled substance at initial access.
Ontario. The Ontario College of Pharmacists says therapeutic substitution “is not included in provincial legislation.” Only pharmacists can order controlled substances.
Quebec. The Ordre des pharmaciens du Québec says the federal technician provisions do not apply because technicians are not regulated professionals there. The Ordre is also asking Health Canada to clarify how some provisions should be read.
Atlantic Canada. New Brunswick has published a detailed implementation resource. PEI is waiting for provincial amendments. Nova Scotia is waiting on Health Canada. We could not find a notice from the Newfoundland and Labrador college. The province passed Bill 19 in June 2026 to align its Pharmaceutical Services Act with the federal rules. A tamper resistant pad is still required when the patient carries a paper prescription to the pharmacy.
What owners should do now
- Update your policies. Rewrite your narcotic and controlled drug procedures for verbal orders, transfers, destruction and delivery, using your college’s rules, not just the federal ones.
- Brief your technicians. What a technician can do depends on your province. Put the limits in writing.
- Fix your counts. The CSR does not set a count schedule. Health Canada’s community pharmacy guidance (CS GD 022) recommends a full manual count at least twice a year, checked against your perpetual inventory.
- Check central fill and pharmacy to pharmacy sales. If you buy from or sell to another pharmacy outside an emergency, it must be to fill a prescription, with a signed written order.
- Watch for college updates. Alberta, Manitoba, Ontario, Quebec, New Brunswick, Nova Scotia and PEI have all said more changes are coming.
Why this matters when you buy or sell a pharmacy
Controlled substance compliance is one of the first things a careful buyer checks. In due diligence, expect questions about loss and theft reports, count and reconciliation records, destruction records and any college findings. Missing records or unexplained losses can slow a deal or change its terms.
The records rule also applies after a sale or closing. If a pharmacy stops operating, the person who was responsible for it on that date must make sure the records are kept for at least two years. Agree in the purchase contract who keeps them and how the other side can get access.
If you are looking at a pharmacy for sale, ask for the last two years of controlled substance records early. Our guide to the pharmacy sale process and timeline covers where this fits.
We are licensed pharmacists who have owned, run and sold pharmacies. If you are planning to sell your pharmacy or buy a pharmacy, contact us for a confidential conversation.
This article is general information, current to October 7, 2026. It is not legal advice. Your provincial college’s rules apply to your practice.