Offering Opioid Agonist Treatment over the holidays? Here’s what you need to know

Offering Opioid Agonist Treatment over the holidays can be challenging for pharmacists, thanks to holiday hours at pharmacies and prescribers taking time off. The College of Pharmacists of British Columbia has offered guidance to pharmacists around this time of year. One component is that pharmacies must have hours of service that will be able to meet the dosing requirements of their patients. To do this, pharmacists must check that they can accommodate all aspects of a prescription, including the start and end dates and any dosing directions, before they accept a prescription. They should ensure that dispensing doesn’t end on a day the patient can’t see a prescriber for a new prescription, such as weekends and holidays, and make sure that the pharmacy is open on days stated in the dosing schedule. Read: The high risk of methadone: What you ought to know about OATPharmacists can request that prescribers write prescriptions for carries. However, the college notes that pharmacists must put their patients’ needs above the pharmacy’s, as disrupting a schedule can harm vulnerable patients. Suppose a pharmacy’s hours don’t match the dosing schedule of a patient over the holidays. In that case, the pharmacist can refer the patient to another pharmacy or collaborate with patients to have alternate opening hours on a holiday that will allow them to receive their prescribed dose. If a pharmacist has concerns or needs further direction and can’t reach the patient’s healthcare provider because they’re on holiday, the pharmacist can take action without them. The College says that the pharmacist should “use their professional judgment to act in the best interests of their patients and to ensure patients receive safe and accessible treatment.” They should document the treatment intervention, including how they tried to contact the prescriber, their therapeutic rationale and their follow-up plans. Afterwards, they should tell the practitioners about the intervention as soon as possible and keep proof of that communication. Two changes from 2020 also apply to this situation. The college said that pharmacists can authorize pharmacy employees to deliver OAT on a pharmacist’s behalf, the college said, but it must be for an exceptional circumstance. The second is an exception from Health Canada regarding controlled substances needed for medical treatments. It allows pharmacists to extend and renew prescriptions, transfer prescriptions to other pharmacists, verbally prescribe prescriptions for controlled substances, and deliver controlled substances to patients at their homes or other locations.Read: Faculties of medicine respond to opioid crisis with new CME and medical school curricula

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