Key Requirements for Methadone Dispensing

Published: June 2012; (Revised April 2017)

Legislative References: Narcotic Control Regulations, s. 27

Additional references: N/A

College Contact: Pharmacy Practice


Methadone is a safe medication when prescribed, dispensed and consumed according to the guidelines in place, but can be extremely dangerous when used inappropriately. It is strongly recommended that good systems and procedures are in place prior to dispensing methadone and that pharmacies develop a policy and procedure manual to facilitate staff training and awareness.


Following is a summary of key requirements that must be in place when dispensing methadone:

1. Notify OCP that the pharmacy is dispensing Methadone

Pharmacist must report to the College within 7 days that they are dispensing methadone.


2. Adhere to OCP Methadone Maintenance Treatment and Dispensing Policy

Pharmacists are responsible for adhering to all requirements as outlined in the

Note: The importance of physician-pharmacist collaboration/communication can not be underestimated. Pharmacists need to verify with Health Canada, that a prescribing physician holds a current/valid exemption which applies to either Methadone Maintenance Treatment (MMT) for opioid dependence or for the treatment of malignant and chronic non-malignant pain. Physicians, who wish to prescribe methadone for both MMT and Pain, must obtain separate exemptions. As these exemptions expire on an ongoing basis, status must be checked regularly.

On March 10, 2017, Health Canada issued a Section 56 Class Exemption for Practitioners Prescribing Methadone to Inpatients in a Hospital Setting.

This class exemption allows practitioners to continue a patient's methadone treatment while the patient is hospitalized without obtaining an individual temporary methadone section 56 exemption. This class exemption applies only when all the conditions of the exemption are met.

To verify if a practitioner is exempted to prescribe methadone contact the Methadone Program directly at exemption@hc-sc.gc.ca, or (613) 946-5139 or 1-866-358-0453.


3. Ensure staff are appropriately trained

In accordance with policy the DM is required to be appropriately trained within the first 6-months of beginning methadone practice and at least one staff pharmacist within a year. In addition, pharmacists are required to update their training, at a minimum, every 5 years. Below is a list of current training available.

*The College is aware that space within the CAMH ODT Core Course is limited, and members may require several attempts at registration before securing a spot. However, additional training opportunities are available and members should explore this training while concurrently pursuing the required course registration with CAMH. It is the member’s responsibility to ensure they have obtained the skills, knowledge and training to dispense methadone in a safe and effective manner, prior to engaging in such practice. Please see training opportunities below.

  • Mandatory Initial Training — CAMH's Opioid Dependence Treatment (ODT) Program
    • Robyn Steidman 416-535-8501 x 36640 or robyn.steidman@camh.ca
    • Satisfies the requirements as per OCP Policy.
    • Training must be completed by DM within the first 6 months of beginning methadone practice and at least one staff pharmacist within a year.
  • OPA’s Addictions Education
    • OPA programs do not satisfy initial training requirements, however, are acceptable for meeting the required training update (required at a minimum every 5 years).
      • Completion of 5 "Opioid Addiction and Substitution Therapy Online Modules" including the mandatory module titled “Policies Guiding Methadone Dispensing in Ontario” and/or
      • Completion of OPA live one-day Methadone, Buprenorphine, and the Community Certificate Program
    • Online Modules and Live Program
      • Are designed to provide pharmacists with tools to effectively manage their patients on methadone maintenance therapy.
      • Available to all pharmacists as an education update at any time in their practice.
      • These complimentary sessions are provided to pharmacists with funding from the MOHLTC
  • CAMH’s Opioid Dependence Treatment: Essential Knowledge for Pharmacy Technicians
      • Online, self paced course for pharmacy technicians and assistants.
      • 5 modules to be completed in one month
      • Pharmacy technicians/assistants that work within opioid dependence treatment practice settings should consider this course.

4. In accordance with policy pharmacies that dispense methadone must have the following required references available:

  • Methadone for Pain
  • Additional (optional) resources include:
    • The OPA Methadone Toolkit for Pharmacists
      • Available to all pharmacists in Ontario free of charge through OPA
    • Opioid Substitution Therapies Drug Information Line (formerly Methadone Line)
      • 1-888-519-6069, Hours: Mon – Fri, 9 a.m. – 5 p.m.
      • The Opioid Substitution Therapies Drug Line provides free access to drug information experts who can answer questions about methadone and buprenorphine/naloxone in the treatment of addiction.
      • The service is free for methadone healthcare providers (funded by the MOHLTC)
    • CPSO’s Patient and Physician Advisory Services
      • 416-967-2600 Ext. 603
      • Service for physicians who want to obtain an exemption to prescribe methadone and a referral service for patients who are looking for an opioid dependence treatment clinic in their area.
    • CPSO's Methadone News
      • Newsletter includes clinical practice guideline updates, practical Q&As, and information on upcoming continuing education opportunities.
    • CAMH’s Addiction Clinical Consultation Service (ACCS)
      • Primary Care Addiction Toolkit: https://www.porticonetwork.ca/web/opioid-toolkit
      • For health care professionals looking for assistance in supporting patients with opioid addiction concerns
      • Provides brief answers to common clinical questions, as well as relevant clinical tools and patient resources.
    • Access CAMH
      • 416-535-8501 press 2
      • Monday – Friday: 8:30 am to 5 pm
      • Quickly access the information you need to facilitate referrals to CAMH
      • Specific drug-related questions can be triaged by Access CAMH to CAMH pharmacists
    • Buprenorphine/Naloxone for Opioid Dependence: Clinical Practice Guideline