For discipline-specific frequently asked questions about the education and training pathway, click on the tabs below:
Where can the workbooks be found?
All workbooks can be found on the resources page.
Do physicians and nurse practitioners need to complete the education and training pathway to prescribe buprenorphine/naloxone?
Physicians and nurse practitioners are not required to complete the education and training pathway in order to prescribe buprenorphine/naloxone, it is optional; however, they are strongly encouraged to take the POATSP Online Course.
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. Learning opportunities will continue to be offered for nurse practitioners for prescribing buprenorphine/naloxone, including online education and in-person preceptorships; however, this is optional.
The BCCSU conducted a review of the nurse practitioner education and training pathway for buprenorphine/naloxone prescribing and consulted with key stakeholders. This confirmed that removing this education and training pathway requirement may better support the expansion of buprenorphine/naloxone treatment, particularly in rural and remote communities.
Nurse practitioners are strongly encouraged to take the POATSP Online Course to learn the latest evidence-based guidance for prescribing buprenorphine/naloxone and for more information about induction protocols.
Do prescribers need to obtain 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.
As per the Prescribing Methadone Practice Standard by the College of Physicians and Surgeons of BC, registrants who do not currently have a section 56(1) exemption, or have not prescribed in more than three years must obtain the relevant 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 does not expire (excluding direct follow up or disciplinary action from the Colleges).
What is the current scope of practice for registered nurses (RNs) and registered psychiatric nurses’ (RPNs) prescribing of OAT medications for opioid use disorder (OUD)?
As of November 2023, the scope of practice includes prescribing of buprenorphine/naloxone, methadone and slow-release oral morphine (SROM). However, RNs and RPNs only prescribe within their individual training and competence and within any limitations placed by the employer. For each medication, there are specific instances where the RN or RPN must consult with or refer to a physician or nurse practitioner. These are outlined specifically in the decision support tools.
Medication | Initiation | Continuations (including missed doses) |
Titrations | Restarts
(up to 30 consecutive days since last dose) |
Buprenorphine/naloxone | ✓ | ✓ | ✓ | ✓ |
Methadone | X | ✓ | ✓ | ✓ |
Slow-release oral morphine | X | ✓ | ✓ | ✓ |
For each medication, there are specific instances where the RN or RPN must consult with or refer to a physician or nurse practitioner. 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 nurses with Certified Practice Opioid Use Disorder (CP-OUD) designation are authorized to diagnose and treat opioid use disorder.
For RNs and RPNs taking the POATSP RN and RPN education and training pathway to diagnose and treat OUD, a formal authorization from the designated regional health authority lead is required.
If you have not yet received authorization from your regional health authority lead and are interested in seeking it, contact the relevant health authority:
- 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]
- Provincial Health Services Authority: [email protected]
Is the POATSP: RNs and RPNs online course different from the original POATSP course?
Yes, the two courses differ. The POATSP: RNs and RPNs online course is tailored toward RNs and RPNs and differs slightly from the POATSP online course intended for physicians and nurse practitioners.
It is therefore important that RNs and RPNs taking the education and training pathway to prescribe OAT medications 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?
In order to complete the education and training pathway to prescribe OAT medications, RNs and RPNs must have taken the POATSP: RNs and RPNs online course.
In addition, RNs and RPNs must have completed the POATSP: RNs and RPNs online course within 3 months of completing the workbook and attending their preceptorship to ensure that they have an adequate working memory of the extensive content covered in this online course. The date of Certificate of Completion is checked before a preceptorship is confirmed.
Will RNs/RPNs 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 is prescribing within the scope of practice outlined in the education and training pathway, as well as their individual training and competence. In this scenario, it is the RNs/RPNs' responsibility to ensure that that they are competent prior to engaging in diagnosing and treating OUD. Registered nurses and registered psychiatric nurses can complete additional education such as reviewing the relevant modules in the POATSP: RNs and RPNs online course and schedule additional preceptorship days as needed and at their own discretion before diagnosing and treating OUD.
For RNs/RPNs who have completed the education and training pathway for buprenorphine/naloxone only and are looking to upskill to methadone and slow-release oral morphine prescribing, additional formal education through the BCCSU is required.
Where do I find out more information about Certified Practice for Opioid Use Disorder?
On September 21, 2023, new and amended standards, limits, and conditions to create a new designation of certified practice for opioid use disorder (CP-OUD) for RNs and RPNs have been approved by the BC College of Nurses & Midwives (BCCNM), effective November 1, 2023.
OUD certified practice RNs and RPNs will be able to diagnose and prescribe controlled drugs for the treatment of OUD. Nurses who currently diagnose and treat OUD under the temporary public health order that want to maintain this authority must transition to this new class of certified practice by December 1, 2023.
BCCSU will maintain responsibility for training RNs and RPNs under the new standards.
For more information about these amendments, please visit the BCCNM website.
For more information about certified practice and the transition to certified practice, please read this FAQ.
Questions not included in this list? Email the BCCSU at [email protected].