OPIOID DEPENDENCE TREATMENT PROGRAM
SUPPORTING EVIDENCE-BASED PRESCRIBING
The CPSA supports Alberta physicians in providing safe, accessible, effective and consistent clinical care to patients who may benefit from treatment with methadone or buprenorphine/naloxone(Suboxone®).
This includes patients who are diagnosed with an addiction disorder, have chronic pain, are in a palliative care setting or have been admitted to hospital when already on an opioid dependence therapy.
Physicians who wish to prescribe methadone must have a Methadone Exemption.
To prescribe methadone for the treatment of opioid dependence or for analgesia in Alberta, physicians must apply to the CPSA for a methadone exemption under section 56 of the Controlled Drugs and Substances Act and meet specific requirements for initiating or maintaining methadone treatment.
To INITIATE methadone treatment you must have appropriate education and experience in a multi-disciplinary setting or postgraduate training.
To MAINTAIN methadone treatment for a patient stabilized by a specialist you must submit with your application a letter of support from the pain, addiction or palliative physician who initiated the methadone treatment for the patient.
Buprenorphine/Naloxone (Suboxone®) Prescribing
Buprenorphine/Naloxone (Suboxone®) is as effective as methadone for treatment of opioid dependence but with an improved safety profile. The agonist/antagonist action of Suboxone® creates a “ceiling effect” which makes it less likely to result in overdose and less attractive to abuse.
Although buprenorphine/naloxone has an improved safety profile compared to methadone, opioid dependent patients are high risk. It is strongly recommended to have a treatment agreement in place and to set appropriate boundaries with patients. Compliance monitoring by accessing PIN, or prescribing databases, and through urine drug screening is also important.
Physicians who wish to prescribe buprenorphine/naloxone for opioid dependent patients in Alberta must be registered to prescribe Triplicate Prescription Program drugs.
Completion of an online buprenorphine/naloxone prescribing course is strongly encouraged.
We recommend the following courses:
- Centre for Addiction and Mental Health (CAMH) Buprenorphine-Assisted Opioid Dependence Treatment courseor
Other equivalent course (Contact us at email@example.com to discuss options.)
- Suboxone Guidelines (CAMH)
- Methadone Standards and Guidelines
- Get Naloxone (AHS)
- Opioid Dependency Phone Consultation (AHS)
- Management of Opioid Use Disorders: A National Clinical Practice Guideline (CMAJ 2018)
- BC Opioid Use Disorder Guidelines
- Slow-Release Oral Morphine (Kadian®) for Opioid-Dependence Treatment in Alberta
- Methadone for Pain in Palliative Care Online Course