Methadone for Analgesia

Physicians wishing to obtain an authorization under section 56 of the Controlled Drugs and Substances Act to prescribe methadone for analgesia must apply to the College in writing using the appropriate (full or temporary) form. Advance notice is required. All information must be submitted before an application can be forwarded to Health Canada. Incomplete application forms will cannot be processed.

To prescribe methadone for analgesia, physicians must use the regular duplicate prescription pad. If a duplicate prescription pad is not available, physicians cannot write prescriptions for methadone and must find alternate care for patients. Physicians should contact the College to confirm the address for courier delivery. Depending on location, temporary authorizations processed on Thursdays and Fridays may not result in receipt of the duplicate prescription pad before the weekend. 

Note: Physicians seeking an authorization to prescribe methdone for opioid use disorder should contact the BC Centre on Substance Use

Requirements for Full Methadone Authorization

The current requirements for obtaining an authorization to prescribe methadone for analgesia are:

Note: A phone interview with a member of the registrar staff may be required prior to approval.

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. 

Apply for an authorization by completing and submitting the Application for Authorization to Prescribe Methadone for Analgesia.

Requirements for Temporary Methadone Authorization

Physicians with temporary authorization to prescribe methadone for analgesia may do so at a patient’s current dose, and may increase or decrease as clinically indicated. Physicians with a temporary authorization must not initiate a patient on methadone for analgesia, and must have a physician with a full authorization act as a resource for them.

Note: Temporary authorizations may be issued for up to a maximum of 60 days. Health Canada will only authorize two back-to-back temporary authorizations for the same patient and physician.

The current requirements for obtaining a temporary authorization to prescribe methadone for chronic pain/palliative patients are:

  • patient name, personal health number and date of birth
  • date exemption needs to start
  • methadone dose and frequency of administration
  • physician to act as a resource (this physician must have a full authorization to prescribe methadone for analgesia and must have agreed to act as a resource for the physician requesting temporary authorization) 
  • an acceptable review of your prescription profile from the PharmaNet database

The current requirements for obtaining a temporary authorization to prescribe methadone as a locum are:

  • period of employment as a locum
  • clinic/facility information including the name of the physician requiring the locum
  • physician to act as a resource for the locum (this physician must have a full authorization to prescribe methadone for analgesia and must have agreed to act as a resource for the physician acting as a locum)
  • an acceptable review of your prescription profile from the PharmaNet database

Apply for an authorization by completing and submitting the Application for Temporary Authorization to Prescribe Methadone for Analgesia.

Patient Information

Please refer to the Patient Information section for more information.
 

Overdose Prevention and Response Training

Toward the Heart is a provincial harm reduction initiative designed to equip members of the public to respond in case of an opioid overdose.

Physicians should consider providing patients who may be at risk of overdose with naloxone. The BC Centre for Disease Control has a Take Home Naloxone Program, which provides information to health-care workers and the public. There is also an Overdose Survival Guide which can be provided directly to patients, their friends and families.

For more information about the program or to find the nearest training site, visit the Toward the Heart website.

Naloxone available in BC without a prescription

Naloxone is available outside of pharmacies without a prescription.  It is important that anyone administering naloxone call 9-1-1 first, and be aware that naloxone may cause withdrawal symptoms for the patient. Family and friends should be adequately instructed on how to recognize the signs of overdose, how to administer naloxone, and how to monitor the patient’s progress until help arrives.

For more information and resources regarding naloxone, visit the College of Pharmacists of BC website.