BUPRENORPHINE Standard for Opioid Dependency
Buprenorphine, an opioid with high affinity for opioid receptors, is a medication which has come to be used to help treat both opioid dependency and chronic pain. The College of Physician and Surgeons of PEI has set these Standards in the hope of preventing inadvertent harm to patients.
The following are the standards expected of physicians to assist them in their prescribing for opioid dependency.
This standard applies to Suboxone and Subutex.
This standard does not apply to Butrans. Butrans is currently only indicated for the treatment of pain and is not indicated for the treatment of opioid dependency. Physicians must be cautioned on prescribing Butrans in an off label use for the treatment of opioid dependency. Off label use of Butrans for the treatment of opioid dependency cannot be endorsed by the Council of the CPSPEI at this time.
Prescriber Criteria
- An unrestricted registration for independent practice in the province of Prince Edward Island, in good standing with no relevant conditions or restrictions.
- No current investigations with regard to prescribing opioids or record keeping.
- No previous findings of professional misconduct or previous legal findings with regard to prescribing opioids or record keeping.
- Successful completion of the Suboxone Education Program, available online at https://www.suboxonecme.ca/ prior to commencing prescribing of Buprenorphine for opioid dependency is expected.
- Review of the Centre for Addiction and Mental Health Buprenorphine Guideline for Treatment of Opioid Dependence available at:
https://www.porticonetwork.ca/documents/489955/0/Buprenorphine+and+Naloxone+-+Clinical+Practice+Guidelines+2012+PDF/fd1eee5d-fd7f-4b58-961f-b45350a8b554 - For a short term, acute care hospital admission for an intercurrent illness, or for an incarceration in a provincial correctional facility, any adjustment of the buprenorphine dose should be on the advice of the physician who is providing ongoing care for the addiction and who recommended and initiated the buprenorphine treatment. For continuance of the maintenance dose, no consultation to this physician is necessary, but the attending physician should be aware of potential interactions with medications used in the acute illness.
- As with any medication, a prescribing physician must maintain currency in the treatment methods of the treated condition. Therefore, commitment to continuing medical education relevant to prescribing Buprenorphine is expected.
For suggested references on relevant courses, please contact the College office.
Documented ongoing proof of the above CME is not required at this time; however, should a complaint arise with respect to prescribing Buprenorphine, absence of appropriate training will be reviewed and could result in a finding of unfitness or professional misconduct.
Document History
Approval Date: June 4, 2018