How often must Ontario pharmacies count narcotics?

Published June 19, 2026

Ontario's OCP expects narcotics reconciled every six months. Nova Scotia and PEI monthly; Alberta, BC, Saskatchewan, Manitoba and Newfoundland every three.

One of the most common questions about narcotic reconciliation is simply how often you have to do it. Here's the cadence in Ontario and how it compares across the rest of Canada.

The Ontario rule

The Ontario College of Pharmacists (OCP) expects narcotics and controlled substances to be reconciled at least every six months — at minimum, twice a year. “Reconciled” means a full physical count compared against the expected on-hand calculated from your records, with any variance investigated, not just a tally on a shelf.

Provinces with a stricter cadence

Several provinces expect counts more often. Nova Scotia and Prince Edward Island are the strictest in the country: narcotics and controlled drugs are counted and reconciled monthly. Alberta, British Columbia, Saskatchewan, Manitoba, and Newfoundland & Labrador generally require reconciliation every three months. In Prince Edward Island, targeted substances are reconciled at least once every six months. If you operate in more than one province, hold yourself to the strictest cadence that applies, and always confirm the current requirement with each provincial college.

Why counting more often helps

The longer the gap between counts, the more purchases, dispenses, and destructions fall inside the reconciliation window — and the harder a variance is to trace back to its cause. Many pharmacies count monthly as a matter of good practice even where six months is the Ontario minimum, because small discrepancies are far easier to resolve while the transactions behind them are still recent. In Nova Scotia and Prince Edward Island, monthly is not good practice on top of the minimum - it is the minimum.

This is separate from dispensing-level reporting

Periodic reconciliation is not the same as your real-time dispensing obligations. In Ontario, the Narcotics Monitoring System (NMS) receives dispensing data in real time from your dispensing software; reconciliation is a separate, periodic exercise that checks your physical inventory against your records.

Sources

Primary sources for the figures on this page. Regulations change; confirm the current requirement with the source before you rely on it.

NarcCount does the reconciliation math for you and flags every variance. Get started or read the worked reconciliation example.

General information, not legal or professional advice. For authoritative requirements, refer to the Ontario College of Pharmacists and Health Canada.