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; 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? As of November 2021, the scope of practice includes buprenorphine/naloxone and limited methadone and slow-release oral morphine prescribing.

Medication	Initiation	Continuations (including missed doses)	Titrations	Restarts (up to 30 consecutive days since last dose)
Buprenorphine/naloxone	Tick	Tick	Tick	Tick
Methadone	Cross	Tick	Tick	Tick
Slow-release oral morphine	Cross	Tick	Tick	Tick

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 prescribe OAT medications? For RNs and RPNs taking the education and training pathway to prescribe OAT medications, a formal authorization from your regional health lead is required. If you have not yet received authorization from your regional health 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]

  Why do I need a health authority lead to authorize my training? Registered nurse and registered psychiatric nurse prescribing of OAT is governed by a Provincial Health Order which requires a health authority Medical Health Officer endorsement for each program where a RN/RPN is actively prescribing. Each health authority in BC has developed a process for submitting authorised RN/RPN prescribers to the BCCSU for training.   Is the POATSP: RNs and RPNs online course different from the original POATSP course? Yes, the two courses differ. The POSTSP: RNs and RPNs online course is tailored toward RNs and RPNs and their scope of practice. 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 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. In this scenario, it is the RNs/RPNs' responsibility to ensure that their competencies are up-to-date. Registered nurses and registered psychiatric nurses can review the relevant modules in the POATSP: RNs and RPNs online course and schedule additional preceptorship days as needed and at their own discretion before prescribing OAT medications. For RNs/RPNs who have completed the education and training pathway for buprenorphine/naloxone and are looking to upskill to limited methadone and slow-release oral morphine prescribing, additional education is required.