Methadone Program

Health Canada has removed the requirement for physicians to obtain an exemption to prescribe methadone for the treatment of opioid dependence or analgesia. While methadone is an important tool in the treatment of these disorders, it is not without its risks. In recognition of the public safety risk that methadone represents if not prescribed appropriately for the treatment of opioid use disorder, the CPSO continues to expect physicians to:

  • give written notification to the CPSO of their intention to begin prescribing methadone for the treatment of opioid use disorder;
  • complete the core Opioid Dependence Treatment course offered by the Center for Addiction & Mental Health (CAMH);
  • complete a minimum of one day’s preceptorship with either a pre-approved methadone prescriber or participate in the CAMH Methadone Preceptorship Simulation Course;
  • be assessed in their methadone prescribing practice for opioid use disorder one year after they begin prescribing methadone. 
  • be knowledgeable about the expectations in the CPSO’s Prescribing Drugs policy, which states that physicians must have the requisite knowledge, skills and judgment in order to prescribe any drug. The Methadone Specialty Panel has an additional requirement stipulating that new prescribers are expected not to prescribe methadone by telemedicine until successful completion of the one year assessment 

The Frequently Asked Questions about the Methadone Maintenance Treatment Program provides answers to commonly asked questions about the methadone program for the treatment of opioid dependence.

MMT Program Standards and Clinical Guidelines

The CPSO developed its MMT Program Standards and Clinical Guidelines, which we approved in February 2011, for use by doctors providing methadone maintenance treatment for opioid use disorder in Ontario in co-operation with both the Centre of Addiction and Mental Health and the Ontario College of Pharmacists. These guidelines remain in effect and are the basis for the prescriber assessment.

Methadone for the Treatment of Analgesia

If the intention is to begin prescribing methadone for analgesia, a physician must be knowledgeable about the expectations in the CPSO’s Prescribing Drugs policy, which states that physicians must have the requisite knowledge, skills and judgment in order to prescribe any drug. They would also be expected to be familiar with current guidelines for prescribing methadone for analgesia and have the requisite knowledge, skill and judgement to prescribe this medication.