opioids
On our Website
• Prescribing Drugs Policy
• The Canadian Guideline for Safe
and Effective Use of Opioids for
Chronic Noncancer Pain
• CDC Guideline for Prescribing
Opiods for Chronic Pain
www.cpso.on.ca/CPD/resources
(see Medical Expert Role Resources)
of Health and Long-Term Care, will
make it easier to identify drug utilization patterns and trends and to
detect unusual prescribing activities,
said Dr. Gerace. The primary use of
the information is to inform harm
reduction strategies, education initiatives, and to improve prescribing
and dispensing practices related to
monitored drugs. However, if there
is suspected illegal activity or professional misconduct, the ministry will
report to law enforcement and to
regulatory colleges as applicable.
“We take the issue of unsafe
prescribing very seriously,” said Dr.
Gerace, “and if there is concern
that a physician is not practising
at the expected standard of practice, we will investigate,” he said.
Sanctions range from restricting the
physician’s practice or requiring the
completion of remediation to the
most serious outcome of revocation.
Different structure for new Canadian opioid guideline
T
notes that, unlike the Canadian guideline, the CDC
he new Canadian guideline for safe opioid
guideline does not list those clinical conditions for
prescribing, which is expected to be released
which there is evidence that use of opioids is not effecin January 2017, will have a different structive. “This would have helped physicians target their
ture than its predecessor. Some of the guidecare,” he said. The 2010 Canadian guideline states that
line will be a summary of expert opinion, as the Centers
opioids only be used for those condifor Disease Control has done in its new
tions where there is evidence of benefit
guideline, and some of the guideline will
and then identifies those that have evibe statements of the existing evidence
dence of benefit and those that do not.
as it addresses the questions driving the
Dr. Buckley acknowledges that there
guideline, with a measure of the strength
are challenges to providing optimal care
of each particular statement.
using opioids, but he said the situation is
The revision now underway has sought
improving for prescribers.
and received input from a wide range
He cites the prescription monitoring
of clinicians and academics with experprograms which are becoming more
tise in guideline development, policy,
available across Canada. Systems in
pain and addiction issues, and from the
Saskatchewan and Nova Scotia are in
medical regulatory bodies, said Dr. Norplace that monitor the prescribing of
man Buckley, scientific director of the
controlled substances and then can trigMichael G DeGroote Institute for Pain
Dr. Norman Buckley, scientific
ger, if needed, educational interventions
Research.
director of the Michael G. DeGroote
Pain
Centre
at
McMaster.
around prescribing for physicians.
Although, the 2010 Canadian guideAnd in Ontario, while narcotic
line has been compared unfavourably
prescriptions are tracked by the Ministry of Health
to the newer U.S. guideline with its more conservative
and Long-Term Care, work continues in developing a
dosing recommendations, Dr. Buckley said the current
formal prescription monitoring program.
Canadian guideline has clear value and advantages. He
MD
22
Dialogue Issue 2, 2016
Issue2_16.indd 22
2016-06-16 12:26 PM