Registered nurses (RNs) and nurse practitioners (NPs) are authorized to administer cannabis for medical purposes in their practice when the client has a Health Canada Medical Document. The following frequently asked questions provide guidance for RNs and NPs.
The new federal Cannabis Act and Cannabis Regulations are the primary law governing cannabis in Canada. Cannabis is no longer listed as a controlled substance under Schedule II of the Controlled Drugs and Substances Act. Legislative requirements for cannabis for medical purposes are outlined in Part 14 of the Cannabis Regulations.
Yes, the federal Cannabis Act and Cannabis Regulations make certain forms of possession, distribution, selling, and importing and exporting of cannabis illegal. Provincial and municipal bylaws may set restrictions about consumption –for example, the Alberta Tobacco and Smoking Reduction Act (Section 3). RNs and NPs must follow the legislation regarding possession, distribution etc. Failure to do so could result in, for example, disciplinary action, civil lawsuit, or charges under the Criminal Code.
Generally, yes. RNs and NPs are authorized to possess and administer cannabis. Subsection 348 of the Cannabis Regulations sets out the requirements for cannabis products and gives permission to an individual in charge of a hospital to allow cannabis products (other than cannabis plants and cannabis plant seeds) to be administered or distributed to an inpatient or outpatient. Each individual hospital setting will make its own policy regarding cannabis for medical purposes (including administration) in its facility.
A hospital is defined as "a facility that is licensed, approved or designated by a province under the laws of the province to provide care or treatment to individuals suffering from any form of disease or illness; or that is owned or operated by the Government of Canada or the government of a province and that provides health services." The definition of "hospital" may encompass facilities other than those identified as hospitals in provincial legislation such as a hospice or a long-term care facility.
Generally, yes. RNs and NPs are authorized to possess and administer cannabis for medical purposes in settings other than those defined as a hospital through employer policy.
In these settings, the nurse has access to the client’s private residence by way of invitation to provide nursing services. The invitation may be "express" through direct communication orally or in writing e.g. inviting the nurse into the home or "implied" through actions or conduct e.g. nodding or gesturing for the nurse to enter the home (CNPS, 2018).
Not currently. The Prescribing Standards for Nurse Practitioners (2018) currently restricts NPs from issuing a medical document for fresh or dried marijuana or cannabis oil or providing a written order.
All clients require a medical document in order to receive cannabis for medical purposes. A client treated in a hospital setting usually requires a written order by a health-care practitioner in addition to the medical document. The written order supports the dispensing and/or administration of the cannabis for medical purposes to the client.
A medical document is “a document provided by a health care practitioner to support the use of cannabis for medical purposes.” The period of use of a medical document cannot exceed one year. A medical document must be signed and dated by the health-care practitioner who is providing it and must include a statement confirming that the information in the document is correct and complete. A written order is defined as "a written authorization given by a health care practitioner that a stated amount of cannabis be dispensed for the individual named in the authorization."
The components of a medical document must include the following:
The components of a written order must include the following:
Yes, you are. RNs and NPs involved at any level of client care may be in possession of and/or distributing cannabis for the purposes of providing treatment to a client. The Cannabis Regulations provide the nurse with the legal authority to possess and distribute cannabis for medical purposes despite the limitations or restrictions in the Cannabis Act. For example, a nurse who possesses cannabis for the purposes of administering it can be found to be in possession of the cannabis. For the purposes of the Cannabis Act, the definition of possession in the Criminal Code is adopted.
“A person is deemed to be "in possession" when the person has the substance in their personal possession, knowingly has it in the actual possession or custody of another person or has it in any place, whether or not that place belongs to or is occupied by them, for the use or benefit of themselves or of another person.
"Distribute" is defined as "administering, giving, transferring, transporting, sending, delivering, providing or otherwise making available in any manner, whether directly or indirectly, and offering to distribute."