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Triplicate Prescription Program update

July 21, 2015

Benzodiazepines added to Alberta prescription monitoring list

In 2013, half a million prescriptions for at least one benzodiazepine were issued in Alberta, similar levels to all opioid prescriptions combined. To help address the province’s growing health issue with drug abuse and misuse, benzodiazepines and benzodiazepine-like medications have been added to Alberta’s Triplicate Prescription Program (TPP). The change is effective July 1, 2015.

Benzodiazepines will be monitored electronically through the Pharmaceutical Information Network (PIN), with no change to prescribing or dispensing. Unlike other drugs on the TPP list, benzodiazepines will not require a triplicate prescription, and prescribers are not required to register with the TPP to prescribe them.

Do I need to change my process of filling prescriptions for these drugs?

  • There are no changes to the legislative or standards requirements for filling a prescription for a benzodiazepine or a benzodiazepine-like medication.
    • TPP prescriptions pads are not required
    • Record keeping requirements are unchanged
    • Verbal prescriptions continue to be allowed
    • Prescriptive authority is unchanged
    • Notification to the TPP program occurs via your regular upload to PIN (Netcare)
  • Due to the potential for abuse or misuse, pharmacists are encouraged to review their processes for ensuring the appropriateness, effectiveness, and safety of prescriptions for benzodiazepines and benzodiazepine-like medications
    • Employ Chat, Check, and Chart when filling prescriptions for these medications
    • Check Netcare prior to filling prescriptions for these medications
    • Develop collaborative relationships with physicians and other health care professionals who are caring for the patient

Why are benzodiazepine-like medications included?

  • Although Zopiclone is not included in the Benzodiazepines and Other Targeted Substances Regulations to the Controlled Drugs and Substances Act it has similar properties, side effects and drug interactions. For this reason a decision was made to monitor it as part of the program. 
  • There are no changes to prescriptive authority. When appropriate, pharmacists may adapt prescriptions for Zopiclone, and pharmacists with additional prescribing authorization may prescribe it.

If the TPP identifies high-risk prescribing patterns, the College of Physicians and Surgeons contacts the physician to discuss the case in more detail. Physicians are also alerted if their patients are seeing more than one physician for the same drug. In late 2013, The Alberta College of Pharmacists (ACP) began providing similar notifications to pharmacists when high risk patients were identified.

The College of Physicians & Surgeons of Alberta (CPSA) operates the TPP on behalf of program partners including Alberta pharmacists, dentists, veterinarians, and nurse practitioners. The program tracks the prescribing and dispensing of drugs subject to misuse and abuse, resulting in improved prescribing and better patient safety.

The program will add codeine-containing drugs in 2016.  Likewise, it will not require a triplicate prescription or registration with the TPP to prescribe these drugs.

For more information please visit the CPSA Triplicate Prescription Program page.