National opioid guideline puts emphasis on harm reduction
The new Canadian guideline for opioid therapy for chronic non-cancer pain urges doctors to take a much more conservative approach to the prescribing of opioids and , broaden the scope of the situations where they do not prescribe opioids at all . Seven of the 10 recommendations in the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain focus on harm reduction , and seek to minimize harm for a range of patients with chronic pain , including people with current or past substance use disorders , other psychiatric disorders , and those who suffer from persistent pain despite opioid therapy . Most significantly , two of the recommendations with the strongest evidence recommend that doctors instead optimize other non-opioid therapies and significantly restrict the daily limit of opioids to less than 90 mg morphine equivalents daily ( MED ). While this dose recommendation is in line with the US Centers for Disease Control ’ s Guideline for opioid prescribing and other recently released guidance , it is a marked departure from the 2010 Canadian guideline , which suggested a “ watchful dose ” of 200 mg MED – a figure criticized by many in the years since for being too high . The guideline ’ s recommendations for clinical practice were developed by an international team of clinicians , researchers and patients , led by the Michael G . DeGroote National Pain Centre at McMaster University and funded by Health Canada and the Canadian Institutes of Health Research . 1 Dr . David Rouselle , College President , said he welcomed the new guideline . “ Prescribing opioids under the right conditions is critical
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We understand the process is being reviewed . We stand by our support of the content and if there are ultimately any changes , we will reflect those accordingly . photo : istockphoto . com
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Dialogue Issue 2 , 2017