Updated Sep. 18, 2020, to clarify nurses' role at this time
BCCNM appreciates the Sep. 16, 2020,
public health order from the Provincial Health Officer (PHO) that temporarily authorizes RNs and RPNs to now diagnose and treat a problem substance use condition or substance use disorder, including by providing opioid agonist treatment and by prescribing pharmaceutical alternatives to illegally produced or street procured drugs, and by referring the client to primary care and specialized health and social services.
BCCNM recognizes the important role that RNs and RPNs can play in reducing opioid overdose deaths and is committed to working with our partners at the Ministry of Health, Ministry of Mental Health and Addictions, the BC Centre on Substance Use, and the PHO to increase access to treatment, particularly as drug toxicity deaths are climbing again in British Columbia.
This public health order follows a recent Health Canada decision granting a
temporary exemption under the
Controlled Drugs and Substances Act to allow RNs and RPNs in British Columbia to prescribe buprenorphine/naloxone (i.e., Suboxone or its generic versions) for the treatment of opioid use disorder. This exemption is subject to specific conditions that include meeting provincial regulations and requirements of BCCNM.
The Health Canada exemption, as well as the PHO's public health order, are both required to enable this new prescribing authority to proceed.
The authority to diagnose a problem substance use condition or substance use disorder and prescribe the types of drugs needed for their treatment is new for RNs and RPNs. There will be rigorous oversight and other safeguards put in place including new standards, limits, and conditions, which are pending approval by the BCCNM board.
RNs and RPNs who prescribe buprenorphine/naloxone for the treatment of opioid use disorder, as allowed by the Health Canada exemption and the PHO's public health order, will need to meet not only standards, limits, and conditions related to the prescribing of medications but additional limits and condition specific to the prescribing of buprenorphine/naloxone.
As always, BCCNM's primary responsibility is public protection—we will continue to collaborate with our government and health system partners over the coming months to ensure our work is informed by best practices and current evidence.