Notice to all Prescribers: Manitoba Prescribing Practices Program (M3P) Update

Details updated February 6, 2023

The College of Physicians and Surgeons of Manitoba (CPSM) and the College of Pharmacists of Manitoba (CPhM) Registrars have authorized an operational change related to the M3P Program effective February 15, 2023. If you are not currently prescribing M3P medications, this change may have an immediate impact on your practice. 

Approval is no longer required.

To prescribe M3P medications in Manitoba, physicians must hold a CPSM Certificate of Practice, have no specific prescribing restrictions, and have the knowledge, skills, and clinical judgement to prescribe these medications safely (thus, prescribing M3P medications is within your scope of practice). While buprenorphine and methadone are M3P medications, they will still require approval from the Registrar, as per the Practice Direction entitled Prescribing Methadone or Buprenorphine/Naloxone.

What impact will this change have on my practice?

Starting on February 15, 2023, physicians will not be required to complete the M3P application form before writing their very first prescription for a medication on the M3P drug list. Typically, this M3P application form was completed when a physician first obtained their CPSM Certificate of Practice to prescribe M3P medications. This M3P application form will no longer be required.

If you did not previously complete an M3P application form, you can appropriately prescribe M3P medications without completing the form starting on February 15, 2023, provided it is within your scope of practice. 

Are the physical M3P prescription pads still in use?

Yes, you can continue to use the physical M3P prescription booklets (pads). Read this article for more information on M3P prescription pads. 

What if I don’t currently prescribe or plan to prescribe M3P medications?

Medical practice is a self-regulated profession and, moving forward, physicians should exercise their professional judgment as to whether they possess the necessary knowledge, skills, and judgment to safely prescribe opioids. Additionally, if your scope of practice means you are likely to encounter patients who may require M3P medications during their medical care, it is expected that you maintain competency to appropriately prescribe such medications.

Is anyone restricted from prescribing M3P medications?

The vast majority of CPSM registrants do not have specific prescribing restrictions. CPSM will include individual physician prescribing restrictions in the CPSM Registered Members list provided daily to CPhM. This list has been identified as the primary method for pharmacists to verify prescriber details as part of evaluating prescription appropriateness (routine pharmacy practice).

Ultimately, this process will allow physicians to self-regulate as they are expected to do in other areas of practice, while maintaining timely access to relevant safety information for pharmacists.