Changes to B.C.'S Opioid Use Disorder Guidelines

Provincial OUD Guidelines

Significant changes have been made to BC Centre for Substance Use (BCCSU)’s  “A Guideline for the Clinical Management of Opioid Use Disorder” (OUD guidelines), which was released in November 2023. Changes have come into place through greater experience and the need to provide more flexibility when treating patients with OUD.

Key changes in the guidelines include shifting away from first/second/third-line treatments to clinical judgement and client goals. This means buprenorphine/naloxone is no longer a first-line treatment, followed by methadone, then SROM. Other updates include changes to OAT dosing, titration, missed doses, and take-home dosing protocols. In addition, the principles of care for all people with opioid use disorder, which includes trauma- and violence-informed care, cultural safety and humility, anti-racism, and person-centred care, have been further expanded in the new guidelines.

The full 2023 OUD guidelines along with the following clinical summary materials, are now available on the BCCSU OUD webpage:

Professional Practice Policy Updates

The updated 2023 provincial OUD guidelines remove the ranking of OAT (i.e., first/second/third-line treatment) and recommends collaborative decision-making based on clinical judgment, client goals and circumstances. Effective November 22, 2023, the College Professional Practice Policies (PPP) – 66 Opioid Agonist Treatment (OAT) and the Policy Guides (Buprenorphine/naloxone, Methadone and Slow-release oral morphine) have been updated to align with the clinical updates in the OUD guidelines.

OAT CAMPP Training

The College of Pharmacists of BC Professional Practice Policy-66 requires all registrants who are employed in a pharmacy providing services related to Opioid Agonist Treatment (OAT) to have successfully completed BCPhA’s Opioid Agonist Treatment Compliance And Management Program For Pharmacy (OAT-CAMPP).

The BCPhA is in the process of updating the content of the Opioid Agonist Treatment Compliance And Management Program For Pharmacy (OAT-CAMPP) with an expected completion in early 2024.

In the meantime, for new pharmacists or pharmacists who are new to B.C., and/or are now providing services related to OAT, the BCPhA the will continue to host virtual workshops for pharmacists to meet the PPP-66 OAT training requirement. The next and final workshop for 2023 will be held on Dec. 7, 2023


On Tuesday, February 13, 2024, the BCPhA, in partnership with the BCCSU, hosted a free pharmacy-focused ZOOM webinar outlining changes to the provincial OUD and policy guidelines. A recording of the webinar is available on the BCPhA e-training portal and an FAQ document based on the questions posed during the session is being developed.