A reminder about prescribing high-potency narcotics for the treatment of opioid use disorder

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In 2022, amendments to Alberta’s Mental Health Services Protection Regulation impacted the prescribing of high-potency opioid narcotics for the treatment of opioid use disorder (OUD). Conventional opioid agonist treatments such as methadone and slow-release oral morphine (SROM) were not impacted by the amendment.

High-potency opioid narcotics include any full agonist opioid drug, such as:

• Hydromorphone
• Diacetylmorphine (pharmaceutical heroin)
• Fentanyl
• Morphine
• Oxycodone

High-potency opioid narcotics for OUD can only be prescribed through licensed AHS Opioid Dependency Programs for narcotic transition services. These medications must also be dispensed by AHS-contracted pharmacies. These requirements do not apply to high-potency opioids prescribed for treating chronic pain or other illnesses.

When prescribing a high-potency opioid narcotic to treat OUD, a corresponding indication must be provided on the TPP prescription form. For example:

• Under Indication for therapy, checking Opioid Agonist Therapy (OAT/ODT)
• Selecting Other (specify) and noting the following indications:
  • Opioid Abuse Disorder (OAD)
  • Opioid Addiction
  • Opioid Use Disorder (OUD)
  • Substance Use Disorder (SUD)

Resources:

• Narcotic Transition Services (Alberta Health)
• Opioid Dependency Program (Alberta Health Services)
• FAQs on the legislative changes (CPSA)
• Opioid Agonist Treatment (OAT) Program (CPSA)
• Safe Prescribing for Opioid Use Disorder standard of practice and Advice to the Profession (CPSA)

If you have questions about prescribing to treat OUD, please email TPP.Info@cpsa.ab.ca.