Ontario regulator tightens safer-supply prescribing rules to curb opioid diversion

Ontario’s College of Physicians and Surgeons of Ontario adopted significant changes to its safer-supply prescribing framework on Tuesday. The new policy makes it mandatory that physicians prescribe safer-supply medications, primarily hydromorphone, only to patients who are concurrently enrolled in opioid agonist therapy such as Suboxone or methadone. Doses must now be taken in the presence of a health-care professional, eliminating the previous allowance for patients to keep the medication at home, while the earlier eight-week prescribing cap was abandoned.

Regulators highlighted police concerns that prescribed hydromorphone is being diverted to the illicit market, though they acknowledged a lack of precise data on the scale of diversion. Board members voiced worries that the rules could disadvantage rural residents and employed individuals who cannot travel to a pharmacy daily, and questioned how to accommodate the roughly 12 % of patients for whom the combined therapy may not be effective. The college said it will monitor outcomes and adjust the policy as needed, with health minister Sylvia Jones having expressed support.