The BCCNM board on Nov. 25, 2021, approved amendments to Nurse Practitioner
Opioid Agonist Treatment Prescribing for Opioid Use Disorder standards, limits, conditions to include prescribing of pharmaceutical alternatives for safer supply. These amendments take effect Jan. 3, 2022.
On July 15, 2021, the British Columbia Ministry of Mental Health and Addictions and the Ministry of Health released Access to Prescribed Safer Supply in British Columbia: Policy Direction.This policy direction addresses the escalating number of deaths occurring every day in B.C. that are due to an increasingly toxic illicit drug supply. The prescribing of pharmaceutical alternatives (such as hydromorphone) is a harm reduction strategy intended to save lives by replacing an illicit toxic drug supply with a safer supply of drugs for those people who are at risk of illicit drug toxicity events and death.
Clients who receive safer supply may or may not have a diagnosis of substance use disorder. They will not be required to engage in Opioid Agonist Treatment (OAT) or other treatment modalities if they choose not to. This is intended to reduce barriers to accessing services such as by serving as an entry point to the health system and other substance use services.
A jurisdictional scan, literature review, and consultations were undertaken to understand the NP role in prescribing safer supply, the potential risks to client safety associated with the prescribing of pharmaceutical alternatives for safer supply, and to inform options to address these risks. The scan found that while other Canadian nursing regulators have established expectations and requirements for NPs in managing opioid use disorder, none have addressed the prescribing of pharmaceutical alternatives for safer supply.
Further consultations were conducted to obtain feedback about proposed amendments to nurse practitioner standards, limits, and conditions. Key informants and audiences consulted included the health authority NP Leads, the Nurses and Nurse Practitioners Association of BC, Regional NP Leads, nurse practitioners with expertise in opioid use disorder, the Ministry of Health, and the British Columbia Centre on Substance Use.