Regulation - LGIC

College of Nurses of Ontario

Regulation Number(s):
Instrument Type:
Regulation - LGIC
Bill or Act:
Nursing Act, 1991
Summary of Decision:
The Ontario Regulation 111/17 was filed with the Registrar of Regulations as O. Reg. 111/17(General) under the Nursing Act, 1991 on April 19, 2017. The regulation was published on e-laws on April 19, 2017 and published in the Ontario Gazette on May 6, 2017.

O. Reg. 111/17 (General) amends O. Reg. 275/94 (General) under the Nursing Act, 1991.
Further Information:
Proposal Number:
Posting Date:
December 22, 2016
Summary of Proposal:
Posted as an Information Item

College Introduction

In Ontario, the regulation of health professions is based on a self-governance model. There are 26 health regulatory colleges governing 28 health professions under the Regulated Health Professions Act, 1991 (RHPA) and their respective health profession Acts. Health regulatory colleges operate at arm's length from the provincial government and independently administer their own internal processes.

Under the RHPA and the Nursing Act, 1991, the College of Nurses of Ontario (CNO) is responsible for governing the self-regulating profession of nursing in Ontario. Under these Acts, the CNO has the authority to make regulations on a variety of subject matters, including with respect to the performance of controlled acts by nurses, subject to the prior review of the Minister of Health and Long-Term Care and the approval of the Lieutenant Governor in Council.

Summary of Proposal

A controlled substance (example: fentanyl) is a medication that is restricted by federal law because it presents a high risk of misuse, addiction and diversion. Controlled substances are used in healthcare to treat a wide variety of conditions including pain and anxiety. Changes to federal laws (Controlled Drugs and Substances Act), which took effect in 2012, authorized nurse practitioners to prescribe controlled substances. However, there is currently a provision in the Controlled Acts Regulation that prohibits nurse practitioners from performing this activity.

The proposed amendments will enable nurse practitioners to prescribe controlled substances in accordance with the regulations if two conditions are met:

1. meet existing requirements related to prescribing; and,

2. complete education that teaches and assesses competencies to safely, effectively and ethically prescribe controlled substances.

The CNO is proposing the following amendments to its Controlled Acts Regulation:

• Extend the scope of practice of nurse practitioners to include prescribing controlled substances in accordance with regulations under the Nursing Act, 1991; and,

• Require nurse practitioners to complete CNO Council-approved education to be able to prescribe controlled substances and comply with existing conditions in the regulation associated with prescribing drugs. The CNO Council-approved education may be independent of or part of the education and training required to become a nurse practitioner.

The proposed regulation was originally circulated to members and stakeholders for feedback on December 15, 2016.

To view and respond to the proposed amendments, please use the following link to the CNO's website:

Alternatively, the CNO may be contacted with the following information listed below:
Contact Address:
Contact: General Inquiries
Phone: 416-928-0900
Toll Free: 1-800-387-5526
Effective Date:
April 1, 2017