Precautions in place due to the COVID-19 pandemic such as physical distancing, self isolation, and quarantine are impacting clients requiring prescriptions for drugs under the Controlled Prescription Program (CPP). Patients at particular risk are those on opioid medications for chronic pain or those receiving opioid agonist therapy (OAT).
The Ministry of Health, the College of Pharmacists of BC, BCCNP and others are working toward a solution. In these exceptional times, prescribers are asked to ensure their patients have an unbroken supply of these medications. If it is not possible to meet with a patient face-to-face, prescribers should consider alternative means to getting duplicate prescriptions to pharmacies.
Health Canada has provided temporary exemptions to parts of the Controlled Drugs and Substances Act (CDSA) and its Regulations to permit pharmacists to extend prescriptions, transfer prescriptions, and for pharmacists and pharmacy employees to deliver controlled medications, and to permit prescribers to issue verbal orders for controlled medications.
The College of Pharmacists of BC has amended its bylaws relating to the Pharmacy Operations and Drugs Scheduling Act (PODSA) and the Health Professions Act (HPA). During the pandemic, it is now acceptable for prescribers to fax prescriptions, or give verbal prescriptions for controlled drugs to pharmacists, and then deliver (by mail courier or other means) a hard copy of the original duplicate form. It is essential the pharmacists receive the original duplicate form as soon as reasonably possible.
Clinicians are expected to weigh carefully the risks and benefits to both patients and the public when prescribing by these means. The need for physical distancing and self isolation and the risks of travel to medical appointments for clinicians and patients must be balanced with the overarching need to ensure continuous supply of these essential medications. NP prescribers are reminded that they must continue to meet BCCNP standards, limits and conditions for prescribing CDS and OAT, and follow their employer policies and guidelines.
To further enable access to these controlled prescriptions, pharmacists can now provide emergency supplies of controlled drugs (including OAT). Pharmacists are also able to deliver these medications when it is safe and in the best interest of the patient to do so, which includes practising physical distancing and screening for potential COVID-19 exposure.
The BC Centre on Substance Use has developed updated clinical guidance for prescribers and pharmacists to improve access to OAT in the context of COVID-19. Visit their website to access these resources.