Nurse practitioners in B.C. can now prescribe opioid substitutes

Minister of Mental Health and Addictions announced changes at UVic’s School of Nursing

Nurse practitioners in B.C. will now be able to prescribe opioid substitute medications to those experiencing addiction, the province announced Wednesday.

Minister of Mental Health and Addictions, Judy Darcy, said the expansion is about providing more tools for those on the front lines of the escalating crisis, when addressing health professionals and nursing students at the University of Victoria.

“This change is critically important and the reason is pretty basic. You need to be alive in order to have a pathway to recovery,” Darcy said.

On Feb. 14, the College of Registered Nurses of British Columbia expanded prescribing standards to allow nurse practitioners to prescribe medications like injectable hydromorphone, buprenorphine-naloxone and methadone.

“Let’s call it what it is– safe alternatives to the poisonous street drugs that are taking so many lives,” Darcy said, adding the crisis is now claiming an average of four lives a day in the province.

In the seven months preceding that change, the number of physicians providing opioid substitution therapy increased 60 per cent and the number of new patients receiving such care increased 126 per cent.

Nurse practitioners will undergo training from the B.C. Centre on Substance Abuse in order to ensure compassionate, holistic care is provided, Darcy said, and the ministry – created in 2017 – will continue to consult nurses as it develops its strategy for mental health and addictions.

This includes consideration of other social factors impacting addiction such as housing, poverty, and challenges facing youth aging out of care. The province is also partnering with the First Nations Health Authority; Indigenous people face rates of addiction that are three times higher than the non-Indigenous population.

“If we’re going to build a better system, we really need all hands on deck,” the minister said.

In a round table setting, nurse practitioners joined students from UVic’s nursing program, as well as staff from Insite in Vancouver to pose questions directly to the minister.

Sarah Jesshope, a second year student nurse practitioner asked how the changes will align with the ministry’s new mandate to increase access to primary care, a significant struggle for those with mental illness and addiction.

“They’re integrally linked,” Darcy said. “Nurse practitioners are absolutely vital in primary care. Among other reasons, being able to take the time and really deal with all aspects of a person’s health.”

Hundreds of thousands of British Columbians don’t have access to a family doctor, and don’t necessarily know that what they really need is a nurse practitioner, she added.

Nurse practitioners are working on the front lines, Jesshope said, adding these changes will increase access to care across the board.

“As a student we work in many different areas of health care, that can include acute care, emergency. We work with all age groups, but yes the opioid crisis is affecting every platform, every family,” she said.

The federal government has also taken a nod from B.C.’s guidelines and effective May 19, 2018, prescribers will no longer require an exemption to prescribe substitute medications beyond a hospital setting.

“Our goal as a ministry is to get to a place where people living with mental illness and addiction are treated with the same dignity and the same respect and have access to the same quality of care as people living with any other ailment,” Darcy said.

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