On December 19, 2025, the Ministry of Health approved changes to CRNS Bylaws that removed the requirement for Nurse Practitioners (NPs) to obtain Registrar approval to prescribe methadone for the management of pain.
This change is reflected in CRNS Council Policy 2.7. As of February 17, 2026, NPs are not required to obtain approval from the Registrar to prescribe methadone or buprenorphine solely for the purpose of pain management and specializations for this practice area will no longer be captured on the Nurse License Check.
Key practice considerations for NPs prescribing methadone for pain management:
- Methadone can be used for the treatment of severe pain associated with chronic conditions or cancer.
- NPs must only prescribe and/or administer a drug they have the knowledge, skill and judgement to do so safely and effectively.
- CRNS highly recommends that NPs who plan to prescribe methadone for pain management complete Methadone for Pain Management education such as methadone4pain.ca and reach out to a provider experienced in prescribing methadone for pain for further education and consultation when required.
- Methadone:
- is listed in the Panel of Monitored Drugs (CPSS Regulatory Bylaw 18.1);
- must be prescribed cautiously and in accordance with prescribing requirements for controlled drugs and substances; and,
- dosing must be tailored to each patient.
- Prescribers are strongly encouraged to provide the indication for prescribing (e.g., chronic pain) on methadone prescriptions to enhance communication with the pharmacist and assist the pharmacist with accurate transmission to the Pharmaceutical Information Program.
- Saskatchewan Coroners Service concludes accidental or intentional methadone related deaths are commonly associated with unauthorized use. As with all controlled drugs, NPs should be cognizant of diversion potential and be mindful of potentially fraudulent requests for this drug.
NPs who require the authority to prescribe methadone or buprenorphine for the treatment of addiction continue to require Registrar approval per CRNS Regulatory Bylaw XII, Section 3(d)i.1.
For more information, on the prescribing requirements for the treatment of opioid use disorder, please visit the CRNS website or contact the Opioid Agonist Therapy Program at OUD@crns.ca.