How often must Ontario pharmacies count narcotics?

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. British Columbia, Saskatchewan, Manitoba, and Newfoundland & Labrador generally require reconciliation every three 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 minimum, because small discrepancies are far easier to resolve while the transactions behind them are still recent.

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.