Methadone is an important tool in treating certain disorders, but the associated risks demand an added level of diligence.
Health Canada no longer requires physicians to obtain an exemption to prescribe methadone for the treatment of opioid dependence or analgesia. But because of the public safety risk methadone represents if not prescribed appropriately, the CPSO still expects 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 one-day 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; and
- Be knowledgeable about the expectations in the CPSO’s Prescribing Drugs policy, which states physicians must have the requisite knowledge, skills and judgment in order to prescribe any drug.
The Frequently Asked Questions about the Methadone Maintenance Treatment (MMT) 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 for doctors providing methadone maintenance treatment for opioid use disorder in Ontario in co-operation with CAMH 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 physician intends to prescribe methadone for analgesia, they must be knowledgeable of the expectations in our Prescribing Drugs policy. They are also expected to be familiar with current guidelines for prescribing methadone for analgesia and have the requisite knowledge, skill and judgement to prescribe this medication.
Physicians who Wish to Delegate Authority for Methadone Administration
Physicians who wish to delegate their authority for methadone administration for the treatment of opioid dependence are expected to be familiar with and comply with the Methadone Maintenance Treatment for Opioid Dependence policy.