Easing suffering: Ontario nurse practitioners given authority to prescribe high-dose painkillers

A change in the scope of practice for some nurse practitioners in Ontario will allow them to offer greater pain relief to people nearing the end of life. The provincial government has granted nurse practitioners, trained in palliative care, the authority to independently prescribe high-strength opioids.

Previously, nurse practitioners had to consult with palliative care physicians before prescribing the opioids

The Ontario government has granted nurse practitioners, who are trained in palliative care, the authority to prescribe high-dose, long-acting opioids. (University of Calgary)

A change in the scope of practice for some nurse practitioners in Ontario will allow them to offer greater pain relief to people nearing the end of life.

The provincial government has granted nurse practitioners, who are trained in palliative care, the authority to independently prescribe high-strength, long-acting opioids.

"Time is of the essence," says Lois Barlow, an attending nurse practitioner in primary health care who works in long term care in Niagara Falls.

'No reason for them to suffer'

"When you've got somebody with symptoms at the end of life, there is absolutely no reason for them to suffer," she said.

Up to Februay 9, only physicians registered under the ministry of health's palliative care facilitated access (PCFA) program could independently prescribe high-strength, long-acting opioids such as morphine (200 mg tablets and capsules) and hydromorphone (24 mg and 30 mg capsules) to people receiving palliative care. Nurse practitioners had to consult with a PCFA physician before their patients had access to those high-strength drugs, the Registered Nurses Association of Ontario (RNAO) explained in news release earlier this month.
Lois Barlow is an attending nurse practitioner in primary health care working in long term care in Niagara Falls. She believes allowing trained nurse practitioners to prescribe high-dose painkillers is important to the care she delivers. (Lois Barlow )

Barlow, who was part of a group consulting with the Ministry of Health on the change, believes allowing trained nurse practitioners to prescribe these drugs themselves is "incredibly progressive."

'Takes some of the fear away'

"I see it as removing barriers for adequate pain and symptom control," she said, adding that it allows patients "dignity, comfort and the confidence they will be managed and not abandoned at time of need."

"It takes some of the fear away, because there is enough fears around the end of life, there's enough challenges," said Barlow.

The PCFA program is open to all nurse practitioners in Ontario who have expertise in palliative care. More information on how to register for the program is available here