OPIOID AGONIST TREATMENT PROGRAM
SUPPORTING SAFE & ACCESSIBLE CLINICAL CARE
We support physicians in providing safe, accessible, effective and consistent clinical care to Albertans who may benefit from opioid agonist treatment (OAT).
This includes people living with a substance use disorder, those with chronic pain in a palliative care setting or those in hospital undergoing opioid agonist treatment.
Our goal is to ensure Albertans with a substance use disorder receive good medical care.
Methadone is a long acting opioid agonist used for the treatment of opioid use disorder and, less frequently, chronic pain. There is strong evidence for benefits from methadone therapy such as reduced cravings, treatment retention and lower mortality rates.
However, prescribing methadone can be challenging because of its unique pharmacological profile and serious risks such as the potential for drug interactions, dose-related poisoning and cardiac arrhythmias.
Alberta physicians are required to have specific education and training in order to prescribe methadone safely for their patients. For initiating or maintaining methadone treatment, physicians must apply to the CPSA for methadone approval.
NOTE: In-hospital prescribers do not require CPSA approval to maintain patients on methadone. However, any changes to the methadone dose must be done in consultation with the initiating prescriber or their delegate.
Buprenorphine/Naloxone (Suboxone®) Prescribing
Buprenorphine/Naloxone (Suboxone®) is as effective as methadone for treatment of opioid use disorder 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 for people with a substance use disorder. Overall, buprenorphine/naloxone has an improved safety profile compared to methadone.
Physicians who wish to prescribe buprenorphine/naloxone for patients with an opioid use disorder in Alberta must be registered with TPP Alberta.
Completion of an online buprenorphine/naloxone prescribing course is strongly encouraged.
We recommend the following courses:
- 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
- Methadone for Pain in Palliative Care Online Course
- Slow-Release Oral Morphine for Opioid Use Disorder Treatment in Alberta
- CPSA standard of practice on Prescribing: Drugs Associated With Substance Use Disorders Or Substance-Related Harm