Dialogue Volume 13 Issue 1 2017 | Page 26

The report was developed to address the need to monitor and track opioid use in Ontario, and to support evidence-based policy and program decision making in the province. The College believes that prescribing opioids under the right conditions is critical for good patient care. Equally important is that the College effectively address unsafe prescribing practices and reduce the risks that such practices pose to patients. The College is currently investigating a number of physicians who, based on NMS analysis of dispensing data, may be prescribing opioids in a manner inconsistent with Canadian guidelines. The goal is to ensure that physicians have the resources and information they need to safely and appropriately prescribe opioids to their patients. MD

The number of hydromorphone dispenses has increased steadily over the past several years. During the same period, oxycodone and oxycodone compounds, and codeine and codeine compounds remained the most commonly dispensed opioids, with 600,000 or more dispenses each per quarter.

Number of dispense evenTS of selected opioids, by fiscal quARTer, Q2 2012 / 13 1 to Q4 2014 / 15 700,000 600,000 500,000 400,000 300,000 200,000 100,000 0

Oxycodone and oxycodone compounds

Codeine and codeine compounds

1

Q1 2012 / 13 data are incomplete and have been excluded. The NMS was not fully operational until mid-Q1( May 12, 2012).

Top two prescribers of opioids

Family practice / general practice

Dentists

Accounting for 55 % of all prescribers

FP / GPs most often prescribed codeine, codeine compounds, oxycodone, oxycodone compounds, hydromorphone. Dentists primarily prescribed codeine, codeine compounds.

Percent of prescribers 1 by selected specialties Specialty

Percent Family practice / general practice( FP / GP) 38.4 Dentistry 16.7

Surgery( incl. general, orthopedic, plastic, neuro, cardiothoracic, vascular and thoracic)

Internal medicine 4.5 Psychiatry 2.7 Pediatrics 2.0 Obstetrics / gynecology 2.0 Nurse practitioners 2 1.9 Anesthesia 1.4 Emergency medicine 0.8

1

Excludes prescribers of MMT or Suboxone and generics.

2

Nurse practitioners are authorized to prescribe pain relievers containing tramadol or tapentadol.

4.8

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Dialogue Issue 1, 2017