In March 2023, amendments to the Mental Health Services Protection Regulation (under the Mental Health Services Protection Act) had a significant impact on the way pharmacy teams provide care to those being treated for opioid use disorder. Specifically, these amendments changed the way certain opioids, referred to as “designated narcotic drugs,” may be prescribed, dispensed, compounded, and administered.
Pharmacy teams are reminded to comply with the following:
- The Regulation defines a “designated narcotic drug” as any full-agonist opioid drug including hydromorphone, diacetylmorphine, oxycodone, morphine, and fentanyl; however, buprenorphine, slow-release oral morphine, and methadone (referred to as “conventional OAT treatment medications” in the Narcotic Transition Services fact sheet) are excluded from the definition.
- A pharmacist or other authorized regulated health professional may not prescribe, administer, compound, dispense, or sell a designated narcotic drug for opioid use disorder, except as permitted by the Mental Health Services Protection Regulation.
- A pharmacist or other authorized regulated health professional may only dispense a prescription for a designated narcotic drug directly to a patient if the prescription
- includes the indication for which the drug is being prescribed, and
- is NOT indicated for an opioid use disorder.
- Administration of a designated narcotic drug for opioid use disorder must only occur at the location of a licensed Alberta Health Services clinic and supervised by an authorized regulated health professional.
Alberta Health’s Narcotic Transition Services fact sheet provides more information, including detail about hospital-based exemptions to certain requirements.
Requirements for pharmacists
When providing care to patients, particularly those who are engaged in treatment for opioid use disorder, pharmacists must
- collaborate with patients and prescribers to help transition care to/from Narcotic Transition Services programs when required,
- ensure every designated narcotic drug prescription dispensed has an indication provided by the prescriber,
- NOT dispense a prescription for a designated narcotic drug directly to a patient if the prescription is indicated for an opioid use disorder, and
- NOT renew a prescription for a designated narcotic drug for a patient if the indication is for opioid use disorder.
Pharmacists should be aware that an indication for opioid use disorder may be written in different ways and may include terms such as “safe supply” or “addiction.” It is not permitted to dispense for this indication, except as authorized by the Mental Health Services Protection Regulation. If you have a question about the prescriber’s intention, ACP encourages pharmacists to collaborate with prescribers to ensure your patients’ medication needs are met within the boundaries of this legislation.
Regulated members are reminded to review the Opioid Agonist Therapy Guidelines to provide care to those patients who have been transitioned by the program to methadone, buprenorphine, or sustained-release oral morphine.
