Position Paper: The Pharmacy Technician’s Role in the Handling of Controlled Substances – 2018
Introduction
Pharmacy technicians play an important role in the delivery of high-quality health care. The pharmacy technician and pharmacist must work collaboratively so that their combined expertise is used to optimize the care and services provided to patients. This document provides recommendations for the legislative changes necessary to support optimized pharmacy practice in the context of the procurement, receipt, preparation, provision, storage, destruction and related record keeping of narcotics, controlled drugs and targeted substances.
Background
Registered pharmacy technicians are a new class of health professional in Canada. Their education and training uniquely qualifies this group of pharmacy professionals to ensure the quality of the drug distribution system from the point of procurement through to delivery to the patient.
In June 2013, amendments were made to define “pharmacy technician” within the Food and Drug Regulations.[1] These amendments also recognized that pharmacy technicians can transfer and receive verbal prescriptions. The inclusion of pharmacy technicians in these activities is reflective of the appropriate utilization of the skill set of qualified health professionals.
In the context of handling narcotic and controlled drugs, regulated pharmacy technicians are recognized as appropriate witnesses to the destruction of substances by pharmacists and practitioners.[2] With expanding scopes, pharmacist practice has shifted from being distributive in nature, and yet pharmacists remain solely accountable for ensuring guidelines are followed in pharmacies in order to mitigate the risk of diversion from the supply chain.[3]
Despite the existence of a nationally approved framework to guide pharmacy technician practice[4], legislative action to recognize the practice of pharmacy technicians has been slow.
Scope of Practice
Pharmacy technicians apply their expertise when performing activities related to the distribution of scheduled drugs and controlled substances. Applying legal requirements to practice, including federal and provincial/territorial legislation, policies, by-laws, and standards are expectations of entry-level pharmacy technicians. As pharmacy distribution specialists, pharmacy technicians are the natural discipline to take the lead on all distributive activities related to handling narcotics, controlled drugs, benzodiazepines and other targeted substances.
The education, knowledge and skills of the pharmacist are more suited to the provision of patient-focused, clinical healthcare services. Pharmacists provide a holistic, clinical approach to achieve optimal drug therapy outcomes for patients.[5]
Benefits
Better utilization of the skill sets of various healthcare professionals can improve patient outcomes and reduce burden on the health care system. With the growing opioid crisis, the role of the pharmacist in assessing and counselling individuals using opioid medications is more important than ever.[6] If pharmacy technicians are permitted to fulfill a role they are qualified to perform – the handling of controlled drugs – pharmacists in turn will be able to focus their expertise for the greatest benefit to patients.
Granting legislative authority to pharmacy technicians will allow for the consistent application of processes to fulfill the necessary tasks that adhere to policies. While pharmacists redirect their attention to prevention, treatment and harm reduction strategies, pharmacy technicians will provide for the continued protection of controlled substances against loss or theft, and reduce the likelihood of diversion.
Due to the salary differential between pharmacy technicians and pharmacists, appropriate redistribution of these responsibilities is also a cost reduction strategy when considering the significant time required to complete these regulatory tasks accurately.
Call to Action
The PTSA urges pharmacy regulators to take action in order to change the Controlled Drugs and Substances Act and related regulations to grant pharmacy technicians authority to procure, receive, prepare, provide, store, destruct and maintain related record keeping. PTSA also encourages pharmacy technicians and pharmacists to actively advocate for these changes.
[1] Health Canada. Canada Gazette: Regulations Amending Certain Regulations Concerning Prescription Drugs (Repeal to Schedule F to the Food and Drug Regulations). Available from: http://canadagazette.gc.ca/rp-pr/p2/2013/2013-06-19/html/sor-dors122-eng.html
[2] Narcotic Control Regulations. Sections 30 – 49 Available from: http://laws-lois.justice.gc.ca/eng/regulations/C.R.C.,_c._1041/
[3] Health Canada. Guidance Document for Pharmacists, Practitioners and Persons in Charge of Hospitals: Handling and Destruction of Unserviceable Stock Containing Narcotics, Controlled Drugs or Targeted Substances. Available from:
[4] National Association of Pharmacy Regulatory Authorities. Model Standards of Practice for Canadian Pharmacy Technicians. Available from: http://napra.ca/sites/default/files/2017-08/Model_Standards_of_Prac_for_Cdn_PharmTechs_Nov11.pdf.
National Association of Pharmacy Regulatory Authorities. Professional Competencies for Canadian Pharmacy Technicians at Entry to Practice. Available from: http://napra.ca/sites/default/files/2017-08/Comp_for_Cdn_PHARMTECHS_at_EntrytoPractice_March2014_b.pdf.
[5] National Association of Pharmacy Regulatory Authorities. Professional Competencies for Canadian Pharmacists at Entry-to-Practice. Available from: http://napra.ca/sites/default/files/201708/Comp_for_Cdn_PHARMACISTS_at_EntrytoPractice_March2014_b.pdf
[6] Canadian Pharmacists Association. Opioid Crisis. Available from: https://www.pharmacists.ca/advocacy/opioid-crisis/