On May 19, 2018, Health Canada removed the requirement for an exemption under section 56(1) of the Controlled Drugs and Substances Act to prescribe methadone. Subsequently, the College of Physicians and Surgeons of British Columbia has released appropriate guidance on prescribing methadone, a Methadone for Analgesia Guidelines, and a new Prescribing Methadone practice standard.

Physicians are expected to acquire the relevant education and training to prescribe methadone for analgesia and/or opioid use disorder as outlined in the standard, be familiar with the Safe Prescribing of Opioids and Sedatives practice standard, and commit to regularly reviewing each patient’s PharmaNet profile.

Methadone for Analgesia

Physicians with limited experience with the use of methadone for analgesia are strongly encouraged to consult with an experienced colleague before starting a patient on methadone. It is not recommended to initiate methadone in patients who are considered opioid-naïve (no prior exposure to, or intermittent use of, opioids), except in certain palliative or end-of-life care situations.

To prescribe methadone for analgesia, physicians must use the regular duplicate prescription pad. To prescribe methadone for opioid use disorder, physicians must use the methadone controlled prescription pad. Please ensure timely ordering of prescription pads in order to maintain continuity of care for patients.

Consult the Controlled Prescription Program for information on how to order duplicate or methadone prescription pads. Physicians should contact the College to confirm the address for courier delivery.

Methadone for Opioid Use Disorder

Physicians seeking education and guidelines regarding the use of methadone or other treatments for opioid use disorder should contact the BC Centre on Substance Use.