New Recommended Practice Manual Launched to Support Opioid Agonist Therapy Prescribers in Manitoba

WINNIPEG, MB – May 25, 2023 – The College of Physicians and Surgeons of Manitoba (CPSM) launched the Manitoba Opioid Agonist Therapy (OAT) Recommended Practice Manual today. With opioid deaths and overdoses rising, the manual is a tool to guide OAT prescribers in delivering life-saving treatment for individuals affected by Opioid Use Disorder (OUD).

OUD is a chronic and potentially life-threatening illness that profoundly impacts all aspects of a person's life. Fortunately, effective long-term treatment is more accessible than ever in Manitoba.

The Recommended Practice Manual is the first of its kind. It was written by local experts and provides detailed guidance and expert recommendations for every aspect of OAT care. OAT treatment teams can include physicians, nurses, pharmacists, clinic managers, and allied health staff.

Unlike any other resource of its kind, it was developed within the context of Manitoba and addresses local care needs, barriers, and advocacy issues identified by providers who have spent years doing this critical work across the province.

The Recommended Practice Manual covers a range of topics and detailed descriptions across 26 chapters, including:

  • The role of OAT in treating opioid use disorder OUD.
  • Considerations for initiating and discontinuing treatment.
  • Recommendations for the treatment of various patient populations and circumstances.
  • Resources and tools to support prescribers in their practice.
  • Buprenorphine-specific and methadone-specific guidance.
  • Guidance regarding third-line treatment options.


With increased OAT prescribers and access points in the province, the manual serves as a roadmap, equipping prescribers with guidance to provide effective treatment and reduce harm at 28 access points in Winnipeg and 33 in rural and Northern Manitoba First Nations communities.

"In 2015, there were only 9 OAT prescribers in Manitoba and now we're up to 231," said Dr. Marina Reinecke, Working Group Chair, Medical Project Lead, editor, and co-author of the manual. "A repository of knowledge, experience, and infrastructure did not exist then. The manual goes above filling a gap; it sets a standard of care for reducing harm and providing life-saving treatment," she added.  

Prescribers and their patients are already benefitting from the manual. One physician often refers her patients to the manual because she believes patients deserve to know what to expect and that they are being treated to the same standards as others.

"As OAT care becomes more common, patients, providers, and the public can be confident that recommended practices are accessible and responsive to the changing landscape of the opioid epidemic as it unfolds," said Dr. Jas Mancer, who practices addictions medicine at the Manitoba Opioid Support and Treatment Clinic.

"Without access to the manual, incorporating OAT into my family practice and transitioning into addictions medicine would have been much more difficult. With differing approaches to OAT in other jurisdictions, it is necessary to offer consistent, high-quality, evidence-informed care to all Manitobans who need OAT and, above all else, that the care is safe."

The manual is available online at no cost. It can be downloaded as a whole, or each chapter can be downloaded individually. It is intended to be an online publication to permit more regular revision. It will be updated periodically as evidence and best practices in this field evolve.

The manual also contributes to quality assurance in OAT practice, promotes collaboration among professionals and patients, and inspires continued growth of the OAT community in Manitoba.


About The College of Physicians & Surgeons of Manitoba (CPSM)

CPSM is the medical regulatory body that oversees the practice of medicine in Manitoba. CPSM's role is to protect the public and promote the safe and ethical delivery of quality medical care by physicians in Manitoba. 


Media Contact: 

Wendy Elias-Gagnon

Communication Officer

The College of Physicians and Surgeons of Manitoba