Prescribing methadone—consultation results point to an effective standard

A total of 179 registrants participated in the recent consultation on the College’s Prescribing Methadone practice standard, which ran from August 28 to September 28, 2018. 

Results:

 

  • 62% indicated that they had past experience prescribing methadone to their patients, and that they did so most commonly to treat opioid use disorder
  • 80% indicated that the standard is clear and easy to understand, that it aligns well with other standards and guidelines related to prescribing methadone, and that it helps promote patient safety
  • 55% agreed that the Prescribing Methadone standard helps prescribers feel more confident; 20% were neutral

One area of concern raised about the current standard is the requirement of a physician to complete a comprehensive, biopsychosocial examination of a patient before prescribing methadone. Consultation feedback showed that the wording in the standard is not conducive to team-based care as it specifically states that the physician must be responsible for conducting the assessment. The wording for this requirement has now been revised to enable other health-care professionals to conduct the patient assessment before methadone is prescribed, thus promoting the primary care network model. The physician continues to hold responsibility for ensuring that all aspects of the assessment have been completed.

Further feedback from the survey indicated that the standard could provide more clarity regarding best practices for hospital-based physicians when the need arises to prescribe methadone in the emergency department. This concern, along with a few other feedback points, have been passed along to the BC Centre on Substance Use to be addressed in clinical guidelines. 

The revised Prescribing Methadone practice standard was approved by the Executive Committee, and published to the College website.

The College thanks all those who participated in the consultation.