As of Feb. 14, 2018, prescribing opioid agonist treatment (OAT) for opioid use disorder is within the scope of nurse practitioners (NPs).
The standards, limits and conditions for OAT set out the requirements for both induction and continuation/maintenance prescribing of opioid agonist treatment for opioid use disorder. These standards, limits and conditions do not apply to prescribing opioid agonists for pain and other symptoms.
a.substance use disorders including opioid use disorder, b. treatment strategies for opioid use disorder (e.g. opioid agonist treatment, psychosocial treatment interventions), and
c. harm reduction strategies for opioid use disorder.
a. make or confirm a diagnosis of opioid use disorder using the DSM-5TM diagnostic criteria,
b. review the client’s medication profile and history through PharmaNet and other sources,
c. assess for other substance use disorders and/or concurrent use of substances (e.g. alcohol, benzodiazepines, other sedative-hypnotics), and d. develop a treatment plan that takes into account any risks identified during the client’s assessment.
a. additional education offered by the British Columbia Centre on Substance Use2, and b. a preceptorship that meets the requirements established by the British Columbia Centre on Substance Use.
Online education and preceptorship information as well as
clinical care guidance for OAT can be found on the
BCCSU website. Please
contact them if you have questions about the education and preceptorship requirements for OAT prescribers.
Opioid agonist drugs used for the treatment of opioid use disorder are controlled drugs under the
Controlled Drugs and Substances Act. The
Narcotic Control Regulations require methadone prescribers to hold an exemption from Health Canada under section 56 of the Controlled Drugs and Substances Act.
Note: methadone maintenance pads that are initially available will have College of Physicians and Surgeons of BC ID numbers on them.
CRNBC will apply for this exemption on your behalf when you submit you first order for methadone prescription pads.
Note that it will take a number of weeks for the section 56 exemption to be granted, and another three to four weeks for the printer to process the order and send out the pads. You may order up to three pads at a time.
Methadone for analgesia remains out of scope for nurse practitioners.
Prescription pads will be delivered by Xpresspost. The ordering NP is
the only person who can sign for them.
At the time of delivery:
Canada Post will attempt delivery twice. If delivery is unsuccessful, the order will be forwarded to CRNBC. CRNBC will then contact the NP to organize delivery.
Note: As the pads will now be delivered directly from the printer, processing and shipping time for your order will increase to
three to four weeks. When planning your orders, factor in this added time. You may now order up to three pads at a time.