Where can the workbooks be found?
All workbooks are available on the resources page.

Do physicians and nurse practitioners need to complete the education and training pathway to prescribe buprenorphine/naloxone?
No, physicians and nurse practitioners are not required to complete the education and training pathway to prescribe buprenorphine/naloxone. However, it is strongly encouraged that they complete the POATSP Online Course to stay current with best practices.

Why do nurse practitioners no longer need to complete the education and training pathway to prescribe buprenorphine/naloxone?
As of April 22, 2022, nurse practitioners are no longer required to complete the education and training pathway to prescribe buprenorphine/naloxone. This change followed a review by The British Columbia Centre on Substance Use (BCCSU) and consultations with key stakeholders. The review determined that removing this requirement could support broader access to buprenorphine/naloxone treatment, particularly in rural and remote communities.

Learning opportunities will continue to be offered for nurse practitioners for prescribing buprenorphine/naloxone, including online education and in-person preceptorships. While the training is optional, nurse practitioners are strongly encouraged to complete the POATSP Online Course to ensure they remain informed about the latest evidence-based practices and induction protocols for buprenorphine/naloxone prescribing.

Do prescribers need an exemption under subsection 56(1) of the Controlled Drugs and Substances Act (CDSA) to prescribe methadone?
No. As of May 19, 2018, Health Canada removed the requirement for clinicians to obtain an exemption under section 56(1) of the CDSA to prescribe and administer methadone.

According to the Prescribing Methadone Practice Standard from the College of Physicians and Surgeons of BC, registrants without a section 56(1) exemption, or those who have not prescribed methadone within the last three years, must complete the appropriate education and training through the BCCSU.

Is a renewal for prescribing opioid agonist treatment (OAT) medications required?
No renewal is required. Once prescribers have obtained a Proof of Completion letter, it does not expire, except in cases where follow-up or disciplinary actions are required by their college.

For more information about RN/RPN Opioid Use Disorder Certified Practice (CP-OUD) please read the full FAQ.

What is the current scope of practice for registered nurses (RNs) and registered psychiatric nurses’ (RPNs) with CP-OUD?

As of November 2023, the scope of practice for RNs/RPNs CP-OUD includes prescribing of buprenorphine/naloxone, methadone and slow-release oral morphine (SROM). Starting in September 2024, extended-release buprenorphine will also be included in their scope of practice. RNs/RPNs CP-OUD must prescribe within the boundaries of their training competence, and employer-imposed limitations.  There are circumstances for each medication, where consultation with or referral to a physician or nurse practitioner is required. These are outlined in the decision support tools.

How can RNs and RPNs become authorized to diagnose and treat OUD?

As of December 1, 2023, only RNs/RPNs CP-OUD are authorized to diagnose and treat opioid use disorder.

To obtain authorization, RNs/RPNs must complete the CP-OUD education and training pathway through a designated regional health authority lead. If they are not supported by a health authority, RNs/RPNs who want to become CP-OUD should contact [email protected] to enter the non-health authority CP-OUD pathway. The following emails can be used to contact the relevant regional health authority leads:

• First Nations Health Authority: [email protected]
• Fraser Health Authority: [email protected]
• Interior Health Authority: [email protected]
• Northern Health Authority: [email protected]
• Island Health Authority: [email protected]
• Vancouver Coastal Health Authority: [email protected]
• Providence Health Care Authority: [email protected]
• Provincial Health Services Authority: [email protected]

Is the POATSP: RNs and RPNs online course different from the original POATSP course?

Yes, the POATSP: RNs and RPNs online course is specifically tailored to meet the needs of RNs and RPNs, whereas the original POATSP online course was designed for physicians and nurse practitioners.

It is therefore important that RNs and RPNs CP-OUD taking the education and training pathway diagnose and treat OUD (including prescribing, dispensing, compounding, ordering and administering OAT) take the POATSP: RNs and RPNs online course.

What if the RN or RPN has already completed the POATSP Online Course before they were authorized to take the education and training pathway?

To complete the education and training pathway, RNs/RPNs CP-OUD must have taken the POATSP: RNs and RPNs online course, even if they had completed the original POATSP course earlier.

In addition, RNs/ RPNs CP-OUD must have completed the POATSP: RNs/ RPNs online course within 3 months of completing the workbook and attending their preceptorship to ensure retention of the material. The Certificate of Completion date for POATSP is verified before a preceptorship is confirmed.

Will RNs/RPNs CP-OUDs need to complete additional training before writing a prescription if there has been a gap between completing the education and training pathway and being able to prescribe OAT medications (e.g., 6 months)?

No additional training is required provided that the RN/RPN CP-OUD prescribing within the scope of practice training and competency. It is the responsibility of the RNs/RPNs CP-OUD to ensure they are fully competent before diagnosing and treating OUD. To maintain their skills and competency RN/RPN CP-OUD are encouraged to do the following:

• Consult the BCCNM Scope of Practice Guidelines for details on Opioid Use Disorder Certified practice
• Review relevant modules in the POATSP: RNs and RPNs online course
• For gaps in CP-OUD practice of a year or more: contact the BCCSU education team at [email protected] to request an eligibility questionnaire. This applies if the RN/RPN would like to be considered for additional preceptorship time and meets the requirement of working in a role where they will practice as an RN/RPN CP-OUD.
• Refer to the BCCSU Certified Practice Opioid Use Disorder Decision Support Tools

RNs/RPNs CO-OUD who initially completed the education and training pathway for buprenorphine/naloxone and wish to expand their scope to include methadone and slow-release oral morphine prescribing, and extended-release buprenorphine must complete additional education through the BCCSU.

Where can I find out more information about Certified Practice for Opioid Use Disorder?

On September 21, 2023, the BC College of Nurses & Midwives (BCCNM) approved new and amended standards, limits, effective November 1st, 2023. These changes established a new designation for the Opioid Use Disorder Certified Practice (CP-OUD) for RNs and RPNs

Under the new designation, RNs/RPNs CP-OUD will be authorized to diagnose and prescribe controlled drugs for the treatment of OUD. Nurses currently diagnosing and treating OUD under the temporary public health order must transition to this new certified practice by December 1, 2023. Refer here for more information on the transition to certified practice. BCCSU will maintain responsibility for training RNs/RPNs CP-OUD under the new standards.

BCCSU will maintain responsibility for training RNs and RPNs CP-OUD under the new standards.

For more information about these amendments, please visit the BCCNM website.