Guest Post: RN and RPN designation to treat opioid use disorder Oct. 30, 2023

Guest Post: RN and RPN designation to treat opioid use disorder

Effective November 1, 2023, a new designation of certified practice approved by the BC College of Nurses and Midwives (BCCNM) allows registered nurses (RNs) and registered psychiatric nurses (RPNs) to diagnose and treat OUD, including prescribing controlled drugs and substances. The new designation also allows them to issue orders to non-certified practice nurses, to compound, dispense, and administer drugs and Schedule IA medications for the treatment of OUD.

In September 2020, following a temporary exemption under the Controlled Drugs and Substances Act, the Provincial Health Officer (PHO) issued an order temporarily authorizing RNs and RPNs to diagnose and treat OUD by prescribing alternatives to illicit drugs, including buprenorphine/naloxone.

The new certified practice designation makes this prescribing authority permanent.

RNs and RPNs who currently diagnose and treat clients with OUD under the PHO order Registered Nurse and Registered Psychiatric Nurse Public Health Pharmacotherapy must transition to the new certified practice designation by November 30, 2023, to maintain their prescribing authority. RNs and RPNs diagnosing and treating OUD under the PHO order have already met the education requirements for certified practice in OUD, including the requirements to prescribe. No additional education is required.

Currently, certified practice nurses can be authorized to only prescribe buprenorphine/naloxone, methadone, and slow-release oral morphine (Kadian). The list of drugs that can be prescribed for OUD may expand in the future. Prescriptions of Schedule IA medications written by RNs and RPNs must meet the requirements of the BC Controlled Prescription Program.

Please note that BCCNM has concurrently amended its scope of practice standards to restrict prescribing to RNs and RPNs who hold a certified practice designation. This is effective Dec. 1, 2023.

What are certified practice nurses?

Certified practice nurses are allowed within their scope of practice to diagnose a disease, disorder, or condition, and treat it by prescribing, compounding, dispensing, administering, or ordering medications according to their certified practice designation. These nurses follow specific Decision Support Tools that set the parameters for this expanded scope of practice.

DSTs for all areas of CP except OUD are maintained by the Nurses and Nurse Practitioners of BC:
https://www.nnpbc.com/professional-practice/decision-support-tools/

DSTs for CP-OUD are maintained by the BC Centre on Substance Use:
https://www.bccsu.ca/provincial-opioid-addiction-treatment-support-program-poatsp/resources/

Resources

• Prescribing for RN certified practice nurses
• Prescribing for RPN certified practice nurses