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The Legal Regulation of MMT

From: Chapter 3: The Fundamentals of Methadone Maintenance Treatment, in Methadone Maintenance: A Counsellor's Guide to Treatment (© 2003).

In Canada, the prescribing of methadone is subject to more legal regulation than the prescribing of most other drugs. First, the prescribing of methadone is subject to the same laws governing the prescribing of other opioids such as morphine. Second, physicians are required under federal regulation to obtain a special exemption from the federal minister of health before prescribing methadone.

In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) is responsible for ensuring the quality of care provided by methadone-prescribing physicians. This is accomplished by various means. First, the CPSO determines the education, training and other qualifications that Ontario physicians must have to become authorized to prescribe methadone for opioid dependence. These qualifications include structured, academically centred training. Second, the CPSO acts on complaints about methadone-prescribing physicians. Third, the CPSO carries out peer-based assessments of the practices of methadone prescribers for the purpose of quality improvement.

Adherence to the Methadone Maintenance Guidelines (College of Physicians and Surgeons of Ontario et al., 2001) and compliance with the college's reporting requirements are monitored during the assessment process. The CPSO also monitors methadone prescribing and identifies potential prescribing problems through its database of Ontario methadone prescribers and recipients. The CPSO shares prescriber information with the Ontario College of Pharmacists (OCP). 

Currently, Ontario pharmacists do not need a special authorization to dispense methadone. In Ontario, methadone is distributed, stored and dispensed under the same laws that govern other opioids.