Facilitate Education
Investigate
Guide
Assess
CPSO OPIOID POSITION STATEMENT
Introduction Canada is in the midst of an opioid crisis, with escalating overdose deaths in multiple provinces and the second high est rate of opioid prescribing / use per capita in the world. Opioid abuse and misuse are highly complex issues involv ing both illicit and prescription drugs, and there are no quick solutions to this problem. While prescription opioids are an important and useful therapeutic tool for select patients with certain conditions, prescription opioids carry risks, even when prescribed and used appropriately. There are many contributing factors to the opioid crisis – socioeconomic, the availability of illicit drugs that are increasingly unsafe, and a lack of sufficient services to support chronic pain, mental health and addiction. However, well-meaning prescribing by physicians has contributed to the problem, and improvements to prescribing practices must be part of the solution. As the regulatory body for physicians in Ontario, the College of Physicians and Surgeons of Ontario is mandated to serve and protect the public. This includes ensuring that physicians appro priately prescribe opioids. We are concerned about the devastating consequences opioid abuse, misuse and diversion are having on patients, their families, and communities – it touches us all.
Addressing the opioid crisis requires system-wide solutions and collaboration amongst government and government agencies, health-care educators, regulators, doctors and other health professionals, and patients. All of the College’ s efforts are grounded in a steadfast commitment to improved patient and public safety. This statement communicates the College’ s role and approach, and highlights the complementary roles of system partners. Physicians are strongly encouraged to read the College’ s recently updated Prescribing Drugs
The objectives of the College’ s Opioid Strategy are to:
Facilitate safe and appropriate opioid prescribing by physicians to patients,
Protect patient access to care, and Reduce risk to both patients and the public.
policy, which reflects the new 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain.
The College’ s Opioid Strategy comprises a fourpronged approach reflecting our mandate, namely to: Guide; Assess; Investigate; and Facilitate Education for Ontario’ s doctors. The strategy is supported through effective communication and collaboration with physicians, the public and health-system partners, and using data and analytics to inform prescribing practices and our regulatory responsibilities.
Elements of our Opioid Strategy which promote appropriate prescribing include:
Guidance Prescribing drugs is a standard component of most physicians’ practices. It is an important area of practice that requires appropriate knowledge, skill and professional judgment. Prescribing is also governed by a complex legislative framework. The College provides guidance and sets expectations of physicians in our Prescribing Drugs policy. While the Prescribing Drugs policy articulates general expectations and principles of good practice that ap-
ISSUE 3, 2017 DIALOGUE 27