Legally Speaking
December 2022
By Nicole Bootsman, Pharmacist Manager, PRP/OATP Programs

Amendments to the OAT Standards and Guidelines/Policy re Buprenorphone/naloxone prescribing for MAINTAINING (Non-Initiating) Physicians for Opioid Use Disorder

In response to a request for urgent review, Council has amended the educational requirement for buprenorphine/naloxone maintenance prescribing for the treatment of opioid use disorder. The previously required OAT course/workshop is now strongly recommended rather than mandatory. All other requirements, including the Registrar’s approval to prescribe for buprenorphine/naloxone maintenance, remain in effect.  This change was intended to facilitate the involvement of all providers, thereby allowing initiating prescribers to focus their time and attention on the care of new patients and patients who are struggling to reach stability.

Bylaw 19.1 defines a “maintaining physician” as a physician who prescribes methadone or buprenorphine to a patient after the patient has been reasonably stabilized on that treatment by an initiating physician. The amended educational requirement only pertains to the prescribing of buprenorphine/naloxone; the requirements for methadone maintaining physicians are unchanged. Please note that to prescribe buprenorphine extended-release injection (e.g. Sublocade®), physicians must receive certification through the drug company. The Certification Program is available at

A reminder that, per bylaw 19.1(e), Registrar approval is not required to prescribe methadone or buprenorphine solely for the purpose of pain control.

Please refer to the OATP Standards and Guidelines which outline the College expectations for providing OAT for the treatment of opioid use disorder. For further clarification and/or assistance with the approval process, please contact the Opioid Agonist Therapy Program at the CPSS by phone at (306) 244-7355 or via email at

  Nicole Bootsman is the Pharmacist Manager, Prescription Review Program and Opioid Agonist Therapy Program, at the College of Physicians and Surgeons of Saskatchewan.