Featured
October 01, 2026
October 2026

NPs and controlled substances: New regulation takes effect

Nurse wearing scrubs selecting medication from a storage cabinet while reviewing a prescription label in a clinical setting.

As of Oct. 1, 2026, the federal government’s new Controlled Substances Regulations (CSR) have come into effect. These regulations introduce changes to how health care practitioners, including Nurse Practitioners (NPs), prescribe, manage and handle controlled substances. All NPs are now required to follow the CSR.

Approved in late 2025, the CSR consolidates several existing regulations and brings together six class exemptions into a single, modernized regulation. It governs activities involving four categories of controlled substances— narcotics, controlled drugs, targeted substances (including benzodiazepines) and restricted drugs — across the health system, including for NPs.

“Oct. 1 represents the next step in strengthening patient safety and quality care when it comes to the use of controlled substances,” said Catriona Mill, Manager, Practice Quality at CNO. “It’s critical for NPs to understand these changes, as they will affect how NPs document, store and manage controlled substances in their day-to-day practice. Ensuring compliance is an important part of maintaining patient safety.”

What this will mean for NPs

  • New safeguards and documentation requirements: NPs must now meet enhanced requirements for protective measures, record-keeping and reporting, including new obligations related to post-consumer returns (unused or expired controlled substances returned by patients).
  • Expanded authority for returns and destruction: Under specific conditions, NPs are now authorized to destroy post-consumer returns of controlled substances and to sell or provide returned substances to a licensed dealer or the Minister.
  • Authority to transport substances: Under specific conditions, the CSR authorizes NPs to send, deliver and transport controlled substances in accordance with the new regulation.
  • Fewer prescribing restrictions: The regulation removes the previous restriction that prevented NPs from prescribing opium and coca leaves. Since these controlled substances are not marketed drugs, any authorized practitioner who wishes to prescribe them must apply for special access through the Health Canada Special Access Program.

CNO support and what’s next

CNO is committed to supporting NPs as they adopt the CSR into their practice. We have updated our Nurse Practitioner FAQs to help you understand what has changed, and we have also updated the Nurse Practitioner practice standard to align its section on controlled substances with the CSR.

If you have any additional questions about the CSR and how it affects NPs’ practice, please contact CNO’s Practice Support.

About CNO

The College of Nurses of Ontario (CNO) is the regulator of the nursing profession in Ontario. It is not a school or a nursing association. CNO acts in the public interest by:

  • assessing qualifications and registering individuals who want to practice nursing in Ontario.
  • setting the practice standards of the profession that nurses in Ontario are expected to meet.
  • promoting nurses' continuing competence through a quality assurance program.
  • holding nurses accountable to those standards by addressing complaints or reports about nursing care.

The College was founded in 1963. By establishing the College, the Ontario government was acknowledging that the nursing profession had the ability to govern itself and put the public's well-being ahead of professional interests.

For the latest information, please see our Nursing Statistics page.

Anyone who wants to use a nursing-related title — Registered Nurse (RN), Registered Practical Nurse (RPN) or Nurse Practitioner (NP) must become a member of CNO.

Frequently Asked Questions

Go to the public Register, Find a Nurse, to conduct a search for the nurse. Contact us if you can't find the person you are looking for.

All public information available about nurses is posted in the public Register, Find a Nurse, which contains profiles of every nurse in Ontario. Publicly available information about nurses include their registration history, business address, and information related to pending disciplinary hearings or past findings.

Unregistered practitioners are people who are seeking employment in nursing or holding themselves out as being able to practice nursing in Ontario, but who are not qualified to do so. They are not registered members of CNO. Only people registered with CNO can use nursing-related titles or perform certain procedures that could cause harm if carried out by a non-registered health professional. CNO takes the issue of unregistered practitioners seriously. See Unregistered Practitioners for more information.

To ensure procedural fairness for both the patient (or client) and the nurse, the Regulated Health Professions Act requires that information gathered during an investigation remain confidential until the matter is referred to the Discipline Committee or Fitness to Practise Committee. CNO will not disclose any information that could identify patients (or clients) or compromise an investigation. See Investigations: A Process Guide for more information.

Information obtained during an investigation will become public if the matter is referred to a disciplinary hearing. If a complaint is not referred to a hearing, no information will be available publicly.

See CNO's hearings schedule, which is updated as hearing dates are confirmed. Hearings at CNO are open to the public and the media. For details on how to attend a hearing, contact the Hearings Administration Team.

A summary of allegations and the disciplinary panel outcomes can be found on the public Register, Find a Nurse. Full decisions and reasons are also available.

Where a disciplinary panel makes a finding of professional misconduct, they have the authority to reprimand a nurse, and suspend or revoke a nurse's registration. Terms, conditions and limitations can also be imposed on a nurse's registration, which restricts their practice for a set period. Nurses can also be required to complete remedial activities, such as reviewing CNO documents and meeting with an expert, before returning to practice.

For detailed information see the Sexual Abuse Prevention section.

Related links