The Provincial Health Officer (PHO) in September 2020
issued an order temporarily authorizing RNs and RPNs to diagnose and treat a problem substance use condition or substance use disorder, as part of its response to the
overdose crisis public health emergency.
BCCNM in September 2020
introduced a new prescribing standard for RNs and RPNs. At the same time, the board also approved RN and RPN scope of practice limits and conditions for prescribing buprenorphine/naloxone to
treat opioid use disorder.
The following BCCNM standards set foundational requirements, including limits and conditions, for RN and RPN prescribing for opioid use disorder:
Note: while the public health order allows RNs and RPNs to prescribe to treat opioid use disorder, it does not allow RNs or RPNs to give a client-specific order for another nurse to administer or dispense drugs to treat opioid use disorder.
You can begin prescribing once you have met
all the following criteria:
Your organization/employer recognizes you as a prescriber
You successfully complete additional education and the preceptorship requirements established by the B.C. Centre on Substance Use (BCCSU)
Your organization/employer has policies, processes and resource in place to support RN prescribing
BCCNM has provided you with a prescriber ID
You participate in the
B.C. Controlled Prescription Program (CPP) and obtain the duplicate prescription pads required to prescribe for opioid use disorder. Nurses who meet the conditions should
log into their BCCNM account to order CPP pads.
You obtain a
Medical Services Plan (MSP) number allowing you to order diagnostic tests specific to prescribing for opiod use disorder
You obtain Pharmanet access
You are in good standing with BCCNM
RNs or RPNs who:
As per regulations, LPNs are not authorized to prescribe medications.
Currently, OUD nurse prescribers are permitted to prescribe buprenorphine-naloxone. Nurse prescribers are not authorized to prescribe any additional Schedule IA medications to treat OUD at this time. OUD Nurse prescribers can also prescribe some adjunct medications for symptom management when prescribing for the treatment of OUD with buprenorphine-naloxone as per BCCSU guidelines and protocols and the OUD prescriber’s organizational/employer policy.
However, on Jan. 28, 2021, the BCCNM board
broadened the limits or conditions to allow for the future expansion of RN/RPN prescribing for opioid use disorder beyond buprenorphine-naloxone (Suboxone) only.
In addition to the other requirements within the Prescribing standard, nurses can assess:
BCCNM has created a resource related to RN and RPN responsibilities and accountabilities when consulting with or referring to other health professionals when prescribing for opioid use disorder (OUD).