Subsection 56(1) Class Exemption for Medical Directors of Land System and Air Medical Response System Licence Holders in Manitoba
Pursuant to subsection 56(1) of the Controlled Drugs and Substances Act (CDSA), Medical Directors of Land System or Air Medical Response System licence holders authorized under The Emergency Medical Response and Stretcher Transportation Act (Manitoba) are exempted for medical purposes from the application of the following provisions of the CDSA and its regulations:
- Subsections 4(1), 5(1), and 5(2) of the CDSA.
In respect of this exemption,
Aeromedical attendant means a person responsible for the assessment and care of a patient during all phases of aeromedical transport, who has successfully completed an aeromedical specialist registry examination approved by the Minister of Health, Seniors and Long-Term Care, is qualified under the Air Emergency Medical Response System Regulation (Manitoba) and is authorized by a Medical Director to administer controlled substances as part of the practice of paramedicine.
Controlled substance means one of the following substances: buprenorphine, diazepam, fentanyl, hydromorphone, ketamine, lorazepam, midazolam, morphine and pethidine.
Medical Director means a person defined as a Medical Director under the Land Emergency Medical Response System Regulation (Manitoba) or Air Emergency Medical Response System Regulation (Manitoba), and who is ultimately responsible for ordering, transporting, storing and providing controlled substances to affected paramedics or aeromedical attendants for a Land System or Air Medical Response System licence holder authorized under The Emergency Medical Response and Stretcher Transportation Act (Manitoba).
Paramedic means a person who is registered as a primary care paramedic, an advanced care paramedic or a critical care paramedic with the College of Paramedics of Manitoba and holds a valid certificate of practice issued by the College of Paramedics of Manitoba under The College of Paramedics of Manitoba General Regulation (Manitoba) of the Regulated Health Professions Act (Manitoba) and is authorized by a Medical Director to administer controlled substances as part of the practice of paramedicine.
Unserviceable controlled substance means a drug product containing a controlled substance that is expired, contaminated, damaged, or any residual controlled substance remaining in a multi-dose vial.
This exemption provides the aforementioned Medical Directors with the authority to possess, transport and provide controlled substances required by the paramedics employed by licensed Land or Air Medical Response System licence holders to which Medical Directors are affiliated.
The exemption is only applicable if the following conditions are met. Medical Directors must:
- Take necessary steps, in accordance with guidelines concerning controlled substances established by Manitoba Health, Seniors and Long-Term Care to ensure the security of controlled substances in storage and during transportation;
- Order controlled substances from a hospital pharmacy in accordance with guidelines concerning controlled substances established by Manitoba Health, Seniors and Long-Term Care;
- Record all transactions involving controlled substances, i.e., date, name and quantity of controlled substances ordered, received, stored in ambulance or aircraft, and provided to paramedics or aeromedical attendants (to be carried on their person);
- Maintain all records with respect to controlled substances submitted by paramedics or aeromedical attendants working for their Land System or Air Medical Response System licence holder;
- Report all incidences of loss or theft of controlled substances in writing to Health Canada within 10 days of discovery; and
- Keep information specified in (3) and (4) for at least two years and make it available to Health Canada upon request.
This exemption replaces the "Section 56 Class Exemption for Medical Directors of Land System and Air Medical Response System License Holders in Manitoba" that was issued on September 30, 2010. This exemption will remain in effect until the date on which this exemption has been replaced or the date on which this exemption is revoked. This exemption will remain in effect until revoked.
Suspension without notice
This exemption may be suspended without prior notice if the Minister deems that such suspension is necessary to protect public health or safety.
Revocation
The Minister may revoke the exemption if they believe that it is no longer necessary or in the public interest.
Changes to terms and conditions
The Minister may at any time change the terms and conditions of this exemption where necessary.
Failure to comply with the terms and conditions of this exemption may, among other things, result in immediate suspension or revocation of this exemption. Such a contravention may, in some cases, also constitute an offence under the CDSA.
Signed for and on behalf of the Minister of Health
Carol Anne Chénard
Director,
Office of Controlled Substances
Controlled Substances and Overdose Response Directorate
Controlled Substances and Cannabis Branch
Health Canada
Effective Date: July 10, 2026