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