Doctors in Ottawa who prescribe safer supply medications to patients with addictions are now working under stricter provincial guidelines after the College of Physicians and Surgeons of Ontario (CPSO) tightened its rules on the practice.
What changed
The CPSO's Board of Directors approved amendments to its Prescribing Drugs policy on May 28, 2026, aimed at clarifying what is expected of physicians who prescribe safer supply, the practice of giving people with addictions pharmaceutical alternatives to street drugs to reduce the risk of a toxic-supply overdose.
Under the updated policy, physicians must now conduct an in-person comprehensive patient assessment before starting anyone on safer supply treatment. Once a patient is on an ongoing safer supply prescription, the CPSO now requires an in-person check-in with a physician at least once every three months, rather than leaving the frequency of follow-up open to interpretation.
Why the College made the change
CPSO Registrar and CEO Dr. Nancy Whitmore said the amendments are meant to make sure physicians are meeting a consistent standard of care. "These targeted amendments are intended to ensure physicians are meeting the standard of care, while reinforcing clear expectations for assessment and follow-up that help mitigate risk," Whitmore said.
The College was careful to note the policy does not ban safer supply prescribing outright, and that tightening the rules on its own does not solve the bigger problems tied to the practice, including drug diversion, where prescribed medications end up sold or traded on the street, and the broader toxic drug supply driving overdose deaths across the province.
The Ottawa angle
Because the CPSO regulates every physician licensed in Ontario, the new assessment and follow-up requirements apply to doctors in Ottawa the same as anywhere else in the province. Any Ottawa physician currently prescribing safer supply, or considering it, now has to build in-person assessments and quarterly check-ins into how they treat patients with opioid use disorder, rather than relying on virtual or less frequent contact.
A debate that goes beyond Ontario
Ontario isn't alone in re-examining how safer supply is prescribed. In British Columbia, the government announced changes back on February 19, 2025 requiring that all prescribed alternatives for new clients be witnessed by a health professional when they're taken, rather than handed out for later use. Together, the two provinces' moves point to a broader shift among regulators toward closer supervision of a treatment that remains contentious among physicians themselves, some of whom argue tighter rules protect patients and standardize care, while others worry added requirements make it harder for people with addictions to access treatment in the first place.
Earlier this month
The debate over how Canada treats addiction isn't limited to prescribing rules. In June, ottown's earlier report covered a federal Conservative MP's bill that would legalize prescribing psychedelics like psilocybin, part of a wider conversation about how doctors treat mental health and addiction.
Sources: College of Physicians and Surgeons of Ontario, College of Pharmacists of British Columbia
