At this time, physicians and nurse practitioners (NPs) do not require an exemption to prescribe buprenorphine/naloxone. However, physicians interested in prescribing buprenorphine/naloxone are strongly encouraged to complete the modules pertaining to this medication (CME accredited) before starting to prescribe.
Nurse practitioners (NPs) who meet the regulatory requirements for NP prescribing of controlled drugs and substances in BC must follow the standards, limits and conditions for the continuation of buprenorphine/naloxone for the treatment of opioid use disorder.
Note: the scope of NP prescribing of opioid agonist treatment in BC is in the process of being expanded to include initiation of buprenorphine/naloxone and continuation and initiation of methadone.
Physicians – this is not required but is available for prescribers who would like extra support before prescribing
Nurse practitioners – this is a requirement as per CRNBC standards, limits and conditions
At this time, physicians do not require an exemption to prescribe slow-release oral morphine, although it is strongly recommended that they hold a valid federal Section 56 exemption.
For prescribers who intend to take on this more advanced prescribing, there is a specific module available in the online course to support your practice. It is also recommended that clinicians complete a preceptorship with a preceptor who has specific experience with that medication. When scheduling a preceptorship, the list of preceptors also includes which medications they routinely prescribe.
Preceptors will assist in the training and mentoring of new prescribers. The BCCSU has developed a process to select preceptors across the province (i.e. each health authority) to ensure adequate coverage to meet the needs for recruiting new prescribers, including nurse practitioners. BCCSU preceptors must meet the following criteria:
- At least three years’ experience in the Methadone Maintenance Program with minimum 20 registered patients and a practice that includes routine inductions
- An acceptable PharmaNet review (as per the CPSBC Standards and Guidelines for Safe Prescribing of Drugs with Potential for Misuse/Diversion)
- Clinical practice adherence to the BCCSU’s Guideline for the Clinical Management of Opioid Use Disorder
Preceptors will be provided with comprehensive training regarding their role and responsibilities. Further, preceptors will be compensated $200 per half-day of teaching and for training sessions required by the BCCSU.