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Introduction

The standards, limits and conditions in this document set out the requirements for prescribing18 opioid agonist treatment for opioid use disorder. These standards, limits and conditions do not apply to prescribing opioid agonists for pain and other symptoms.

Standards

1.

Nurse practitioners prescribing opioid agonist treatment meet the standards, limits and conditions set out in F. Prescribing Drugs.

2.

Nurse practitioners prescribing opioid agonist treatment apply the clinical practice guidelines for the treatment of opioid use disorder established by the British Columbia Centre on Substance Use.

3.

Nurse practitioners prescribing opioid agonist treatment apply knowledge about:

 

a.

substance use disorders including opioid use disorder

 

b.

treatment strategies for opioid use disorder (e.g. opioid agonist treatment, psychosocial treatment interventions)

 

c.

harm reduction strategies for opioid use disorder

4.

When prescribing opioid agonist treatment, nurse practitioners:

 

a.

make or confirm a diagnosis of opioid use disorder using the DSM-5TM diagnostic criteria

 

b.

review the client’s medication profile and history through PharmaNet and other sources

 

c.

assess for other substance use disorders and/or concurrent use of substances (e.g. alcohol, benzodiazepines, other sedative-hypnotics)

 

d.

develop a treatment plan that takes into account any risks identified during the client’s assessment

5.

Nurse practitioners prescribe opioid agonist treatment in a manner that promotes client and public safety (e.g. prescribe as daily witnessed ingestion until the client has sufficient clinical stability and is able to safely store take-home (carry) doses).

Limits and Conditions

1.

Nurse practitioners who only prescribe buprenorphine-naloxone on a continuation basis for the treatment of opioid use disorder must complete:

 

a.

additional education19

 

b.

a preceptorship, of a minimum of two half-days length, under the guidance of a practitioner who has expertise prescribing opioid agonist treatment and treating clients with opioid use disorder

2.

Nurse practitioners who prescribe opioid agonist treatment for opioid use disorder (other than continuation prescribing of buprenorphine-naloxone) must:

 

a.

meet the education requirements of the British Columbia Centre on Substance Use.

 

b.

complete a preceptorship that meets the requirements of the British Columbia Centre on Substance Use

Footnotes

18

Includes initiating, continuing, or discontinuing the prescribing of a drug.

19

Additional education is structured education (e.g. workshop, course, program of study) designed so that nurse practitioners can attain the competencies required to carry out a specific activity as part of nurse practitioner practice. Additional education builds on the entry-level competencies of nurse practitioners, identifies the competencies expected of learners on completion of the education, includes both theory and application to practice, and includes an objective, external evaluation of learners’ competencies on completion of the education. The terms does not refer to a course or program approved by BCCNP for BCCNP certified practice.

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