Issue No. 53 | May 2017

Divisional Digest

Transition of the Methadone and Buprenorphine/Naloxone Program to the BCCSU   View more info

As you may know, the BC Centre on Substance Use (BCCSU) was recently announced by the provincial Health Minister, with a mandate to provide leadership in substance use and addiction research, education, and clinical care guidance. With the establishment of the BCCSU, most components of the current College of Physicians and Surgeons BC (CPSBC) methadone and buprenorphine/naloxone program will transition to the BCCSU, including authorizing exemptions to physicians who wish to prescribe methadone for opioid use disorder under section 56 of the Controlled Drugs and Substances Act. The BCCSU will assume responsibility of the program effective June 5, 2017 and the program will be renamed the Provincial Opioid Addiction Treatment Support Program.

The CPSBC will continue to recommend physicians who wish to prescribe methadone for analgesic purposes. After the transition, the CPSBC will also continue to add the identification of prescribers with an exemption to prescribe methadone for opioid use disorder to the provider services registry. The College will also continue to process the ordering of duplicate prescription pads and will remain responsible for prescription monitoring of controlled substances across the province. The BCCSU will assume all other responsibilities for the provincial opioid addiction program including clinical care guidance, education and training (including preceptorship), and the administrative responsibilities of exemption processing with Health Canada.

In order to improve access and provincial capacity for opioid agonist treatment education for health professionals, the BCCSU is transitioning to an online learning environment paired with an in-person preceptorship. Those seeking to prescribe only buprenorphine/naloxone (Suboxone®) do not need a methadone exemption, however it is strongly recommended that prescribers complete the online training modules for this medication. You can review a list of topics covered in the program on the BCCSU website.

It is important to note that if you are a physician currently in good standing with CPSBC and have a current methadone exemption, there should be little change during this transition to your OAT prescribing practice with the exception of several clinical practice recommendations detailed in the new guidelines. Prior to the expiry of your current exemption, the BCCSU will conduct a three-month PharmaNet review in order to grant a two-year renewal (or alternate duration as recommended by the BCCSU). The PharmaNet review will be in assessed in accordance with the BCCSU Clinical Guidelines for Opioid Use Disorder and the CPSBC Standards and Guidelines for Safe Prescribing of Drugs with Potential for Misuse/Diversion. In order to renew the exemption, prescribers will be required to pass a short online knowledge quiz.

If you have any questions regarding the program or would like to become a preceptor, please contact Amanda Giesler (agiesler@cfenet.ubc.ca).

Sincerely, Evan Wood, MD, PhD, ABIM, FRCPC, ABAM Dip, FASAM
Professor of Medicine, UBC  Canada Research Chair in Inner City Medicine
Director, British Columbia Centre on Substance Use