Any licensed pharmacist may dispense methadone and buprenorphine-naloxone. No exemption or approval is required.
Before dispensing methadone or buprenorphine-naloxone, review the ODT Guidelines and become familiar with relevant clinical guidelines, federal guidelines, and local programs.
As of May 2018, Health Canada no longer requires methadone prescribers to obtain a federal exemption under section 56 of the Controlled Drugs and Substances Act, and that oversight now lies with the various provincial regulators.
Physicians who prescribe methadone in Alberta will still require OAT approval from the College of Physicians and Surgeons of Alberta (CPSA) and will need to re-apply to their college every three years. Current exemptions in place are still active but will need to be renewed as they expire.
When pharmacists receive a prescription for methadone from an Alberta physician, they should direct all confirmation requests to CPSA at 780-423-4764 or 1-800-561-3899 or email email@example.com.
Nurse practitioners (NPs) are not required to apply to CARNA for an authorization to prescribe methadone. Rather, they must complete education and preceptorship appropriate to the area of their prescribing and need only submit proof of this to CARNA upon their request.
If pharmacists receive a prescription from an NP for methadone, suboxone, or any other narcotic or controlled substance, they can check the nurse practitioner’s prescriber list on the ACP website.
If the prescriber is licensed and does not have a condition on their licence restricting them from prescribing controlled drugs and substances, the pharmacist can dispense the medication. As with any medication, if the pharmacist assesses that there is a concern or problem with the prescription they should contact the prescriber and collaborate to clarify and resolve the issue.
For any out-of-province prescriptions, pharmacists should contact the appropriate regulatory body in the prescription’s province of origin as regulations vary by jurisdiction and profession.
No approval is required for physicians to prescribe buprenorphine-naloxone, however CPSA strongly recommends that physicians complete a buprenorphine treatment for opioid use disorders course.
More information on CPSA’s requirements for prescribing for opioid dependence treatment can be found on the CPSA website.