Time-delayed Safes Information for Pharmacy Professionals

Amendments to the Pharmacy Facilities Practice Direction include:

1. A definition for controlled drugs (as defined by Health Canada).
2. A definition for narcotic drugs (as defined by Health Canada).
3. Requirement to have an appropriate secure narcotic safe to store all narcotic and controlled drug inventory. The narcotic safe in community pharmacies must have a time-delay lock set to at least the minimum time required by CPhM.
4. Community pharmacies must display Council approved time-delay safe signage at all public entrances and near the dispensary in view of the public.

The College of Pharmacists of Manitoba Council express their gratitude to all the pharmacy professionals who participated in the 30-day consultation, concluding on June 17, 2023. Council carefully reviewed and considered all the valuable comments and suggestions received during this period, which played a significant role in shaping the Council’s final decision on the motion. Some of the addressed issues during the consultation were:

• Allowing sufficient implementation period to balance pharmacy operational needs with pharmacy and public safety.
• Ensuring a comprehensive public awareness campaign to support the implementation of time-delayed narcotic safes in community pharmacies.
• Mandating standard signage for community pharmacies to alert the public about the use of time-delayed safes for narcotics and controlled drugs.
• Formation of one or more pharmacy security working groups, including representatives from all pharmacy practice settings, to identify vulnerabilities and risks related to pharmacy security and review and revise existing security guidance.
• Ensuring limited dissemination of information about the amendment in registrant, pharmacy technician, and pharmacy portals to minimize alerting potential thieves to the changes.

New Community Pharmacy Applicants:

• New pharmacy opening applications submitted to CPhM on or before August 11, 2023, must meet the requirement to store all narcotics and controlled drugs in a time-delayed safe with a time delay of at least five minutes by January 31, 2024.
• New pharmacy opening applications submitted after August 11, 2023, must meet the requirement to store all narcotics and controlled drugs in a time-delayed safe before the pharmacy can open.

Existing Community Pharmacies:

• All existing community pharmacies must meet the requirement to store narcotics and controlled drugs in a time-delayed safe with a time delay of at least five minutes by January 31, 2024.

While armed robbery rates in Manitoba have tended to be low, the implementation of time-delayed safe requirements in Alberta, Saskatchewan, and Ontario make Manitoba a softer target for would-be thieves. The new time-delayed safe requirements in Manitoba are a proactive measure to prevent an increase in community pharmacy robberies.

Robbery prevention protects pharmacy staff and patients from a potentially fatal and traumatic experience. Ultimately, we are all responsible for the safety of our communities. In pharmacy practice this means decreasing the risk of narcotics and controlled drug diversion to illegal markets and contributing to the opioid crisis.

The purpose of displaying Council-approved time-delay safe signage at public entrances and near the dispensary is to raise awareness among the public about the presence of time-delayed safes in the pharmacy. It serves as a visual deterrent, signaling to potential thieves that accessing the safe will be delayed, increasing the risk of being caught. The signage, combined with a CPhM public awareness campaign, discourages individuals from attempting pharmacy robberies in the first place.

A time-delayed narcotic safe is a safe equipped with an electronic timer that prevents access to the safe’s contents until the correct combination has been entered and a pre-set period of time has elapsed.

The primary purpose of a time-delay safe is to create a waiting period between when the safe is accessed and when it can be opened to deter thieves who want to enter and leave a pharmacy quickly. Waiting for the safe to open increases the risk of a thief being caught and reduces the chance that the pharmacy will be considered a viable target. Prominent signage combined with CPhM’s public awareness campaign will discourage would-be thieves from entering a pharmacy in the first place.

The province-wide use of time-delayed narcotic safes in community pharmacies, combined with signage and public awareness efforts, has been proven to effectively deter robberies in other jurisdictions such as British Columbia and Alberta.

The time-delayed safe’s door should remain shut and securely locked at all times, except when the pharmacy team requires access to fill prescriptions or restock the safe. After the drugs have been retrieved for prescription filling or added to the safe, the door must be promptly closed and locked once more. When a time-delayed safe is propped open, the safety measure’s effectiveness is diminished because the pharmacy could become a target. Please see the next question for tips to integrate a time-delayed safe into your pharmacy’s workflow to balance safety and efficiency.

With some simple adjustments, a time-delayed narcotic safe can be effectively integrated into your pharmacy’s workflow. Here are some tips to ensure a balance between safety and efficiency in your pharmacy:

• Communicate with your patients and clients to manage expectations of the time they may need to wait to pick up their narcotic or controlled drug prescription. Advise them that your pharmacy uses a time-delayed safe to prevent pharmacy robberies and keep people safe and their prescription may take a few minutes longer to process.
• Stock smaller quantities of narcotics and controlled substances to minimize confusion when selecting a product from your safe.
• Prevent crowding of medications by using dividers on shelves and clear labels.

The Ontario College of Pharmacists recently implemented a similar time-delayed safe initiative for community pharmacies. Pharmacy managers Tracey Stewart and Antony Henen emphasized the importance of planning and communication in a recent Pharmacy Connection article. They offered the following tips for integrating a time-delayed safe into a community pharmacy workflow:

• Input the code for the time-delayed safe when you start processing the patient’s prescription.
• While the time-delayed safe is unlocking, enter the prescription details into the computer and conduct the necessary therapeutic checks and patient assessment.
• Use a timer to notify pharmacy personnel when the time-delay period is over and the safe can be opened.
• If there are multiple narcotic and controlled drug prescriptions waiting, prepare them at the same time while you have access to the open safe.

Read the full article, Effectively Integrating a Time-Delayed Safe into your Pharmacy’s Workflow, for more insights.

A narcotic safe meets the specifications of the Pharmacy Facility Practice Direction only when the safe is

• marketed and sold as a safe;
• constructed of solid metal;
• secured such that it cannot be easily removed from the pharmacy. The safe must either be bolted to the ground or be of a size and weight that it cannot be easily removed; and
• equipped with an electronic timer that prevents access to the safe’s contents until the correct combination has been entered and a pre-set period of time has elapsed. The amount of time before the safe opens is customizable and must be set to at least the minimum time required by CPhM.

Other specifications of the safe are entirely at the discretion of the pharmacy facility including size; however, the narcotic time-delayed safe must be large enough to secure your pharmacy’s narcotics and controlled drugs.

Locking narcotic cabinets or narcotic drawers do not meet the requirements of the Pharmacy Facilities Practice Direction.

All narcotics and controlled drugs defined below must be secured in a time-delayed safe:

• A narcotic drug is defined as any substance set out in the Schedule to the Federal Narcotic Control Regulations or anything that contains any substance set out in that Schedule.
• A controlled drug is defined as any drug set out in the Schedule to Part G of the Federal Food and Drug Regulations or anything that contains any substance set out in that Schedule.Benzodiazepines are excluded from the time-delayed narcotic safe storage requirements:
  It is important to note that although pharmacists are expected to ensure the security of all targeted substances within their pharmacy facility, as outlined within Section 7(1) of the Benzodiazepines and Other Targeted Substances Regulations of the Controlled Drugs and Substances Act, it is not a requirement for pharmacies to store targeted substances inside a time-delayed narcotic safe.Please note: This amendment to the Pharmacy Facilities Practice Direction does not change the types of medications that must be stored in a secure narcotic safe. This means the size and configuration of your safe should remain unchanged. Please contact your local locksmith or safe provider to speak to them about retrofitting your existing safe with a time-delay mechanism.

The cost of time-delayed safes can differ based on their size and the provider you choose. If your pharmacy currently has a safe without a time-delay feature, there may be an option to install a retrofit mechanism at a lower cost.

CPhM acknowledges that fulfilling this requirement may result in extra expenses for the pharmacy. It is important to consider that robberies come with their own costs including time off for affected staff members, counselling, replacing stolen inventory, and repairing any damage caused during the robbery. There is also a potential cost to our communities when stolen narcotics and controlled drugs are diverted to an illegal market.

Acquiring a time-delayed safe is a valuable investment in bolstering the safety of pharmacy staff, patients, and the community by ensuring the security of narcotics and controlled drugs.

Many types of safes can be retrofitted with a time-delay mechanism. Contact your local locksmith for more information.

Many thieves will gather intelligence by watching day-to-day pharmacy practices before they commit a robbery. The proper use of a time-delayed safe combined with prominent signage and public awareness discourages would-be thieves from targeting community pharmacies.

Time-delayed safes will contribute to the safety of pharmacy team members, patients and the public, and the security of the pharmacy’s drug supply. A more secure drug supply will contribute to fewer prescription drugs, more specifically drugs of misuse/abuse such as narcotics and controlled drugs, ending up on the street and adding to the escalating opioid crisis.

According to law enforcement and all available evidence, the use of a time-delayed safe neither agitates offenders nor leads to a potential hostage situation. Instead, if communicated to the public effectively, the use of time-delayed safes acts as a deterrent to a robbery happening at all.

After the introduction of time-delayed safes in Alberta in July 2022, Calgary experienced a significant reduction of 80% in pharmacy robberies, whereas Edmonton reported zero pharmacy robberies. Similarly, British Columbia observed a notable decline of 94% in pharmacy

Part of the success of the time-delayed safe requirement in Alberta and British Columbia is attributed to the application of the measure to all community pharmacies. Combined with prominent signage and a public awareness campaign, time-delayed safes for narcotics and controlled drugs are strong deterrents for would be thieves.

CPhM strongly encourages all community pharmacies located in northern or rural communities to contact their local police or RCMP detachment to discuss security measures implemented at the location and to understand what the expected response time for police would be in case of emergency.

Yes, other jurisdictions have seen a reduction in pharmacy robberies after implementing time-delayed safes. For example, after the introduction of time-delayed safes in Alberta in July 2022, Calgary experienced a significant reduction of 80% in pharmacy robberies, and Edmonton reported zero pharmacy robberies. Similarly, British Columbia observed a notable decline of 94% in pharmacy robberies after implementing security measures that mandated the use of time-delayed safes.