Friday Five (May 29, 2020)

This week's edition of the Friday Five.

CPSM Opioid Agonist Therapy Updates

The College of Physicians and Surgeons of Manitoba (CPSM) has updated sections of the Methadone and Buprenorphine Maintenance Recommended Practice Manual in response to significant safety concerns involving community-based methadone inductions for opioid agonist therapy (OAT). A copy of the letter sent to OAT prescribers can be found here.

Pharmacists dispensing OAT must review the updated recommendations for methadone dose titrations during the induction phase below:

  • The initial dose should be 10-30 mg of methadone per day for at least the first three days. Patients at high-risk for methadone toxicity should start on no more than 10-20 mg.
  • During the early stabilization phase for patients new to methadone, doses may be increased by up to 5 mg every 3-5 days, or by 10 mg increments every 7 or more days.
  • During the early stabilization phase for patients new to methadone, prescribers may elect to prescribe a single dose increase of 10 mg after 5 days, but all subsequent 10 mg dose increases should occur no sooner than 7 days apart.  Alternatively, a 5 mg dose increase may be considered 5 days after a 10 mg dose increase.  Caution surrounding serial 10 mg dose increases is emphasized.

Also, a CPSM interprofessional working group with representatives from the College of Pharmacists of Manitoba (CPhM), College of Registered Nurses (CRNM) and other experts is continuing work to develop the CPSM Buprenorphine/Naloxone Recommended Practice Manual for OAT.

Sections of the CPSM Buprenorphine/Naloxone Manual are posted on the CPSM website as they become available.  Most recently, the In-Hospital Care section of this has been released. Previously, Take-Home (Carry) Dosing Recommendations and Unwitnessed (Home) inductions Recommendations were posted on the CPSM website.

Pharmacists dispensing OAT should be familiar with these documents on the CPSM website.  CPhM will be updating the Opioid Agonist Therapy Guidelines for Manitoba Pharmaciststo reflect these changes and new documents at a future date.

Reminder: Record Checks

In response to the COVID-19 pandemic, the College has revised its submission deadline and process.

Please be advised of the following:

  1. The submission deadline for all criminal record and abuse (adult and child) registry checks in the 2020 calendar year is Friday, September 18th, 2020, regardless of individual document expiry deadlines in the calendar year (through December 31st inclusive).
  2. You must submit original documents to the CPhM Office. You may drop off your documents in-person at the CPhM Office (place them in the black drop box to the left of the front entrance) or mail them to us.

Upon submission of all three checks in 2020, you will again be required to submit new record and registry checks in 2025. Please be reminded that even though a criminal record or abuse registry check on file with the College may have not yet expired, pharmacy professionals are required to immediately report to the registrar any changes in the status of these record and registry checks.

Office Closure: Canada Day

Please be advised that the College of Pharmacists of Manitoba (College) office will be closed:

Wednesday, July 1, 2020 to Friday, July 3, 2020, inclusive.

The office will resume regular hours of operation, 8:30 a.m. to 4:30 p.m., on Monday, July 6, 2020.

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba Pharmacy Alumni of Distinction Award

The College of Pharmacy is currently inviting nominations for The Pharmacy Alumni of Distinction Award. This award recognizes graduates of the College of Pharmacy, Rady Faculty of Health Sciences (previously known as the Faculty of Pharmacy) at the University of Manitoba that have demonstrated outstanding achievements and exceptional leadership within the profession, and service to their community at home or abroad. Nominees must demonstrate standards of professionalism to which others could aspire. The deadline for submission of a nomination has been extended to June 15, 2020. For more information on the nomination process, please visit the University of Manitoba website.