Ontario regulator seeks tighter rules on safer-supply opioid prescriptions

The College of Physicians and Surgeons of Ontario is set to decide on a suite of new prescribing rules for safer-supply medications, most notably hydromorphone, at its board meeting on Oct. 13. The draft amendments would require physicians to provide safer-supply drugs only in conjunction with opioid agonist therapy, impose an eight-week maximum duration, and mandate that patients take the medication in the presence of health-care staff.

The regulator argues the measures are needed to prevent diversion of prescription opioids into the black market, a concern highlighted in earlier May policy changes. The proposal has the endorsement of Health Minister Sylvia Jones, who denounced the illicit use of hydromorphone as “predatory prescribing.” Harm-reduction groups, represented by Shelter and Housing Justice Network organizer Lorraine Lam, fear the restrictions could destabilize patients who rely on safer supply and increase overdose risk. The college consulted physicians, municipalities, health-care partners and the office of chief medical officer Kieran Moore, though the latter did not comment.