NP-Pres_coverThis Nurse Practitioner (NP) e-resource and the modules, lessons, and cases studies containing in it are based on Nurse Practitioner Education Competencies for Prescribing Controlled Drugs and Substances (CDS). The competencies were developed by CASN in partnership with an Advisory Committee and with the consensus of numerous experts in this area including nurse educators, practicing RNs and NPs, regulators, and national associations.

The following competencies and indicators were designed to provide direction for nurse practitioner programs across Canada in the area of prescribing CDS.  This resource outlines the competencies related to prescribing controlled drugs and substances that all students in nurse practitioner programs should acquire over the course of their education.

Nurse Practitioner prescribing is not a new role, as such; the competencies presume that foundational prescribing practices are already taught throughout the NP program.  Therefore, the following competencies are not meant to cover prescribing practices as a whole but rather, be specific to prescribing of controlled drugs and substances.

Competency 1

Prescribes and monitors the use of controlled drugs and substances (CDS) in accordance with federal/ provincial/territorial legislation, regulation, and guidelines.


1.1 Demonstrates knowledge of evidence-informed guidelines, legislation, regulation and organizational policies when prescribing or dispensing CDS.

1.2 Demonstrates an understanding of the impact of prescription monitoring systems on CDS prescribing.

1.3 Demonstrates knowledge and ability to use available prescription monitoring systems.

Competency 2

Integrates concepts of safety, ethics and evidence informed practice in decision making pertaining to prescribing CDS.


2.1 Demonstrates knowledge and applies concepts of the pathophysiology of conditions that may require treatment with CDS.

2.2 Applies principles of pharmacotherapeutics of CDS when prescribing or planning treatment.

2.3 Demonstrates understanding of best practices related to the use of CDS and of other pharmacological and non-pharmacological therapeutic options.

2.4 Selects appropriate screening and diagnostic tools to assess safety concerns for tolerance, dependence, substance use disorder patterns and diversion of CDS.

2.5 Demonstrates knowledge of potential risks for individuals, families, households and communities when prescribing CDS.

2.6 Identifies when there is a need to collaborate with other providers in treatment planning and prescribing CDS.

2.7 Performs medication reconciliation when prescribing CDS.

Competency 3

Develops and implements client-centred CDS treatment plans which include education, monitoring and evaluation of outcomes.


3.1 Demonstrates the ability to develop and implement a CDS treatment plan that includes the therapeutic objective and the expected response.

3. 2 Demonstrates the ability to counsel individuals and families about CDS treatment goals, risks and benefits, proper use, and potential side effects.

3.3 Demonstrates an ability to titrate, taper, or discontinue CDS considering relevant guidelines and pharmacotherapeutics.

3.4 Assesses, monitors, and documents inadequate, atypical, or inappropriate responses to CDS treatment.

3.5 Initiates a CDS treatment contract when appropriate or required.

3.6 Demonstrates and applies knowledge of the complexities of substance use disorders.