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Prescribing Methadone – Removal of Health Canada Exemption

Health Minister Ginette Petitpas Taylor announced March 26th the federal government will introduce regulatory amendments to the Controlled Drug and Substances Act (CDSA).

Currently, physicians who wish to prescribe methadone for the treatment of pain or for use in opioid replacement therapy, must apply for an exemption from the CDSA.  For an application to be approved, Health Canada requires a letter of support from the College. The proposed amendments, anticipated to be in place in May, will lift the need for such exemptions.

As with all questions on expanding scope of practice, the College expects physicians intending to prescribe methadone to be well trained.   Although exemptions will no longer be required, MMT prescribers are expected to adhere to the standards and guidelines set out in the College’s Methadone Maintenance Treatment Handbook.  In addition, the College would expect physicians to have taken the relevant courses offered by Centre for Addiction and Mental Health (CAMH).

Methadone is an important tool in the treatment of both pain and opioid use disorder.  It is, however, not without risk.  It is hoped that the announcement by the Health Minister will encourage physicians to enter this field.  The expectation of the College is that those choosing to enter this important field will do so only with the appropriate knowledge and training.