Prescribed Safer Supply Protocols
Sufentanil
February 19, 2025: The Province of BC has announced changes to the prescribed alternatives policy, which will now require all prescribed alternatives to be witnessed by health professionals. This requirement goes into effect immediately for all new clients only. This supersedes the guidance contained in this document.
The BCCSU will release clinical resources to support the safe transition of existing clients from non-witnessed to witnessed doses. Until that time, clinicians should continue to use their clinical discretion for clients currently receiving and benefiting from non-witnessed doses, as described in the below clinical resources.
In July 2021, the Ministry of Mental Health and Addictions, Ministry of Health, and Office of the Provincial Health Officer released Access to Prescribed Safer Supply in British Columbia: Policy Direction, which enables individuals to access a range of medications through prescription to reduce the risk of drug toxicity death due to accessing the illicit drug supply.
The first phase of implementation of this policy allows for the prescribing of certain opioids through regional health authority-run programs and federally funded programs (e.g., SAFER). The new prescribed safer supply protocols are targeted for Health Authorities looking to implement in their regions.
Prescribed pharmaceutical alternatives is not intended for treatment of substance use disorders but is primarily a harm reduction approach as one strategy for reducing the risks of illicit drug toxicity events and deaths.
Monitoring, evaluation, and data collection of prescribed safer supply is ongoing. Protocols include direction for prescribers to include “SA” in prescriptions, which tells the dispensing pharmacist to tag the prescription with a (non-public) identifying code, for program evaluation purposes, in PharmaNet.
About these resources
These resources provide a standardized protocol for the provision of sufentanil as a way to reduce reliance on the unregulated drug supply and associated harms.
Provision of other medications for harm reduction is outside the scope of this protocol. See the BCCSU’s Risk Mitigation in Dual Health Crises: Interim Clinical Guidance for guidance on supporting individuals who use drugs to self-isolate or quarantine due to COVID-19; the BCCSU’s Opioid Use Disorder Practice Update for information on prescribing hydromorphone and/or M-Eslon to help reduce individuals’ reliance on the illicit drug supply and, thus, overdose risk; and the BCCSU’s Stimulant Use Disorder Practice Update for information on trialing stimulant prescribing to help reduce individuals’ reliance on the illicit drug supply and related harms.
This protocol is adapted from PHS Community Services Society’s Sufentanil Policy.
Protocols
