Provincial OUD Guidelines
Significant changes have been made to BC Centre for Substance Use (BCCSU)’s “A Guideline for the Clinical Management of Opioid Use Disorder” (OUD guidelines), which was released in November 2023. Changes have come into place through greater experience and the need to provide more flexibility when treating patients with OUD.
Key changes in the guidelines include shifting away from first/second/third-line treatments to clinical judgement and client goals. This means buprenorphine/naloxone is no longer a first-line treatment, followed by methadone, then SROM. Other updates include changes to OAT dosing, titration, missed doses, and take-home dosing protocols. In addition, the principles of care for all people with opioid use disorder, which includes trauma- and violence-informed care, cultural safety and humility, anti-racism, and person-centred care, have been further expanded in the new guidelines.
The full 2023 OUD guidelines along with the following clinical summary materials, are now available on the BCCSU OUD webpage:
- Table of Key Updates (2017 original guidelines vs 2023 updated guidelines)
- Clinical Summary Resource - provides a high-level overview of the key clinical changes to the 2023 guidelines, and
- OAT-specific summary updates for:
Professional Practice Policy Updates
The updated 2023 provincial OUD guidelines remove the ranking of OAT (i.e., first/second/third-line treatment) and recommends collaborative decision-making based on clinical judgment, client goals and circumstances. Effective November 22, 2023, the College Professional Practice Policies (PPP) – 66 Opioid Agonist Treatment (OAT) and the Policy Guides (Buprenorphine/naloxone, Methadone and Slow-release oral morphine) have been updated to align with the clinical updates in the OUD guidelines.
OAT CAMPP Training
The College of Pharmacists of BC Professional Practice Policy-66 requires all registrants who are employed in a pharmacy providing services related to Opioid Agonist Treatment (OAT) to have successfully completed BCPhA’s Opioid Agonist Treatment Compliance And Management Program For Pharmacy (OAT-CAMPP).
The BCPhA is in the process of updating the content of the Opioid Agonist Treatment Compliance And Management Program For Pharmacy (OAT-CAMPP) with an expected completion in early 2024.
In the meantime, for new pharmacists or pharmacists who are new to B.C., and/or are now providing services related to OAT, the BCPhA the will continue to host virtual workshops for pharmacists to meet the PPP-66 OAT training requirement. The next and final workshop for 2023 will be held on Dec. 7, 2023
Webinar recording available:
Changes to the Opioid Use Disorder Guidelines and what pharmacists need to know
In 2017, the BC Centre for Substance Use (BCCSU) released the first provincial guideline for the treatment of Opioid Use Disorder (OUD). Since the release, the guideline has been updated to align with new evidence and clinical practice changes and to meet the evolving challenges that resulted from unregulated fentanyl and other toxic substances, such as high opioid tolerance.
Mona Kwong from BCCSU and Ann Johnston from the BC Pharmacy Association discuss updates to the provincial guideline for the clinical management of OUD, including updated clinical recommendations on dosing, titration and missed doses, new protocols for take-home dosing and policy guide changes.
The webinar can be found on the BCPhA e-training portal or on the BCCSU OUD webpage under webinar series.