It is undeniable that we are in the midst of a national opioid crisis. Canada is experiencing unprecedented increases in prescriptions for opioids and consequently the number of associated harms, including death. Thus, the need for improved opioid prescriber education – training that is comprehensive, rational and coordinated – is of paramount importance.
The potential for better opioid prescribing practices and the efforts to install them are beset by a clear disconnectedness between standards set by regulatory colleges and the reality of what remains available. British Columbia, in response to recently released guidelines from the Centers for Disease Control and Prevention, set a new protocol that essentially amounts to a maximum dose of 90 MEQ (milligrams of morphine equivalent) for patients facing chronic non-cancer pain. Yet, as just one example, that province’s formulary still carries transdermal fentanyl in doses more than four times this maximum in the form of 100 μg fentanyl patches (400 MEQ).
Prescribing practices are influenced by the decisions made about what is available on formulary. With multiple inconsistent factors influencing prescriber behaviour, physicians are challenged to provide a consistent response. In no other area of medicine is such divergence and inconsistency of prescribing practices apparent.
Policy-makers, regulators, educators, prescribers and the public recognize that it is time to form consistent, rational and safe approach to the use of these potent medications. The Government of Canada’s upcoming opioid conference and summit, from November 18th – 19th in Ottawa, will bring together individuals and organizations that have the authority to combat the opioid crisis. The desired outcome of the summit is a Joint Statement of Action to Address the Opioid Crisis with a prioritized set of actions and a commitment to public reporting. You can view the live broadcast of the Opioid conference at http://video.isilive.ca/hcsc/2016-11-18/english.html
For health professionals interested in building their skill set in Safe Opioid Prescribing, visit http://cpd.utoronto.ca/opioidprescribing for information about U of T’s cutting edge program. You can also join the conversation on Twitter using #safeopioidrx.