Victoria – The first cohort of registered nurses (RNs) is on track to begin prescribing medications for treatment of opioid use disorder, as part of B.C.’s leading-edge overdose response plan. 

Thirty RNs and registered psychiatric nurses (RPNs) will complete their training this month to prescribe buprenorphine/naloxone (commonly known as Suboxone), which is a first-line opioid agonist treatment (OAT) medication. This is the first step in a phased approach to expand RNs and RPNs’ scope of practice to include prescribing addiction treatment medications. It represents a significant change in B.C.’s health-care system and an important move to better support people in under-served, rural and remote areas.

“We are coming up on five years since British Columbia declared overdose a public health emergency, and more than 6,000 people have died because of toxic street drugs since that time,” said Dr. Bonnie Henry, provincial health officer. “The COVID-19 pandemic has put people who use drugs at much higher risk for overdose. This crisis isn’t unique to our province – it’s a national issue – but B.C. is breaking ground when it comes to our response. I want to thank the nurses who have stepped forward to blaze this trail and help build B.C.’s health-system capacity to reach more people and save lives.”

This change follows Henry’s public health order to authorize RNs and RPNs to prescribe some controlled drugs and substances. RNs and RPNs now join family physicians, psychiatrists and nurse practitioners who are already prescribing OAT medications, such as Suboxone. Training will continue with additional cohorts and will advance to include other medications, such as slow-release oral morphine and methadone, to meet the needs of more patients.

Kate Hodgson, RN, practice consultant, substance use – Four Directions Team, First Nations Health Authority (FNHA) –

“Nurse prescribing is a shared milestone for nurses, communities and people who use drugs. This B.C. initiative will directly improve access to life-saving medication and will create much-needed opportunities for nurses to support access to the full spectrum of substance use care for Indigenous rural and remote communities. The Nation-based health centre teams and FNHA community health nurses who have taken on nurse prescribing are creating innovative programs from a place of wellness, compassion and self-determination.”

Cynthia Johansen, registrar and CEO, BC College of Nurses and Midwives (BCCNM) –

“As the regulatory body for nurses and midwives, we are pleased to ensure that standards are in place to support safe prescribing for opioid use disorder by registered nurses and registered psychiatric nurses. Collaboration across the health care system is key to fighting the overdose crisis, and BCCNM is pleased to be a partner in this life-saving work.”

Cheyenne Johnson, interim executive director, British Columbia Centre on Substance Use –

“Nurses play a critical role in connecting people to treatment, representing for many patients the first, and sometimes only, access point to health care. Expanding prescribing to include RNs and RPNs will, for many British Columbians, represent a pathway to addiction treatment and the supports that can follow, from harm reduction to recovery.”

Michael Sandler, executive director, Association of Nurses and Nurse Practitioners of BC –

“The Association of Nurses and Nurse Practitioners of BC is extremely pleased that the first cohort of RNs and RPNs with expanded scope that includes prescriptive authority for buprenorphine/naloxone is well on its way to applying this increased scope at the point of care. Nursing has earned a reputation as one of the world’s most trusted professions that is based on a long history of working with vulnerable populations, including those who use substances. In an effort to save lives, this cohort of nurses can now build off nursing’s history, pave the way for other cohorts and move the profession forward by utilizing this expanded knowledge base and skill set to further support harm reduction as well as increased access to treatment and referral services.”

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