Saskatchewan

Sask. pharmacists temporarily able to prescribe methadone

Following the suspension of several methadone-prescribing physicians, the federal government granted an exemption to a section of the Controlled Drug and Substance Act.

Health Canada allowed the exemption amid the recent suspension of several physicians

All pharmacists in Saskatchewan will temporarily have the ability to prescribe, sell or provide methadone and buprenorphine. (Kevin D. Liles/Associated Press)

Pharmacists in Saskatchewan have been temporarily authorized to prescribe methadone and Suboxone​​, which are used to treat opioid addictions. 

The move comes after the suspensions of several physicians that were able to prescribe the drugs. In late March, Regina physicians Dr. Ashis Paul and Dr. Rajnikant Patel were accused by the College of Physicians and Surgeons of Saskatchewan (CPSS) of unprofessional conduct, improper prescribing and poor record keeping. 

According to Jeana Wendel, registrar Saskatchewan College of Pharmacy Professionals (SCPP), the Regina doctors and others losing their prescribing privileges led to a province-wide shortage of health care professionals able to provide the service.

"This left approximately 1,000 patients potentially without a primary care provider to prescribe OAT [Opioid Agonist Therapy] therapy," said Wendel in an email.

Both methadone and Suboxone — a brand-name drug that contains buprenorphine — are taken on a daily basis to manage narcotic addictions.

Ray Joubert, associate registrar SCPP, said that a "bridging process" was required to make sure patients where able to access the drugs in a ready, safe and reliable manner.

"What this does is it allows the pharmacist to fill that gap until these patients can see a prescriber, physician or a nurse practitioner who has those prescribing privileges," said Joubert.

He said the CPSS was motived to ask for the exemption following the suspension of Paul and Patel.

"That was the seminal event. There were several hundred patients who would have been so called stranded because of these suspensions. The CPSS approached us and asked for our help, in terms of are there any solutions," said Joubert.

On April 1, Health Canada granted exemptions to subsections within the Controlled Drug and Substance Act (CDSA) and the Narcotic Control Regulations (NCR) to allow legal access to and administration of the medicine. Saskatchewan is the first province to ever be subject to this exemption to the CDSA.

The exemption has several conditions that must be followed by both patient and pharmacist, in addition to existing guidelines established by the province. Pharmacists can only prescribe, sell or provide methadone or Suboxone to a patient under their professional treatment at a pharmacy and only for the continuation of a patients treatment. 

Methadone bottles contain specific doses of medication for patients. (Tom Steepe/CBC News)

Karen Shaw, registrar for CPSS, said the time-limited exemption was the best solution to prospect of several patients going without needed care.

"There aren't an awful lot of opiate agonist prescribers. And so the ministry, the region and the college were working to ensure these patients could be safely transferred to another provider," she said.

"We wanted to ensure that no patients would slip through the cracks and be without their prescriptions."

Health Canada authorized the exemption from April 1 to Sept. 30. By the same token, patients are only eligible to receive the controlled substance if they have a prescription issued from Jan. 1, 2019 to March 31, 2019. 

About the Author

Alec Salloum

Journalist

Alec Salloum is a reporter and producer with CBC Saskatchewan. Salloum has worked at CBC Saskatchewan since 2016. Story idea? News tip? Want to say hello? Get in touch at @AlecJSalloum or alec.salloum@cbc.ca

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