Ontario medical regulator proposes stricter rules for safer supply prescriptions

TORONTO — Ontario's medical regulator is proposing sweeping changes to prescribing safer supply drugs, The Canadian Press has learned.

The College of Physicians and Surgeons of Ontario is looking to clamp down on the practice and is set to hold a board of directors meeting next week to decide on the proposed changes.

One change the regulator has proposed in a document on its website is that "physicians must only prescribe safer supply medications in conjunction with opioid agonist therapy," which uses medications such as methadone to treat opioid addiction.

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The college is also proposing an eight-week time limit for physicians to prescribe safer supply, and mandating that it be consumed in front of health-care professionals.

"The proposed amendments build on targeted changes introduced in May and respond to ongoing concerns about the diversion of safer supply medication and the resulting risks to patients and communities," Mickey Cirak, spokesperson for the College of Physicians and Surgeons of Ontario, wrote in an email.

The regulator previously made changes to its drug prescription policy in May that mandated in-person assessments before prescribing narcotics for safer supply, required doctors to offer opioid agonist therapy first, and mandated followups every three months.

The college said it has consulted with a broad range of people and organizations, including physicians, municipalities and health-care partners, as well as the office of Ontario's chief medical officer of health, Dr. Kieran Moore.

Moore's office did not respond to a request for comment or an interview. The college said the initiative to change safer-supply prescription rules is its own and did not come from the provincial government.

The proposal has the support of Health Minister Sylvia Jones.

"Our government does not and will never support the distribution of illegal drugs, including the illicit use of hydromorphone masked as 'safer supply,'" said Satnam Grewal, a spokesperson for Jones.

"We welcome any action from Ontario’s 27 regulatory colleges who set standards and obligations for health-care professionals, including the College of Physicians and Surgeons of Ontario, to crack down on the predatory prescribing of addictive drugs."

Ontario has moved to an abstinence-based model under Premier Doug Ford in its approach to the ongoing opioid crisis. The province closed provincially funded supervised consumption sites and passed a law banning them within 200 metres of schools and daycares.

The province has since opened 29 homelessness and addiction recovery treatment hubs, which the government calls HART hubs. It has spent more than $500 million on that plan, which offers primary and mental health care, addiction services and peer supports.

‘Really dangerous and very destabilizing’

Word of the proposed changes has reached some people who depend on safer supply, said Lorraine Lam, an organizer with the Shelter and Housing Justice Network and a longtime harm reduction worker.

"The changes are really dangerous and very destabilizing," Lam said.

"People are really, really scared and people are really, really anxious and very angry."

She said some people using safer supply got jobs or returned to school and she's worried what will happen to them when they're cut off.

"The reality is people who are on safe supply are going to be de-prescribed really, really quickly, which will increase the chances of people turning to the street unregulated supply, which will then therefore increase the risk of overdoses and deaths," Lam said.

The college's board of directors is set to meet on Oct. 13, when it is expected to vote on the proposed changes.

With files from The Canadian Press, Global News and CBC News