The existing threshold dose for opioids prescriptions in Nova Scotia is about to be drastically reduced as a result of new guidelines from the College of Physicians and Surgeons.
The threshold is currently 200 mg per day of morphine — under new regulations, physicians are being told to use “great caution” when prescribing more than 50 mg per day, and “should avoid exceeding 90 mg a day.”
“So this is a significant tapering back of what is an acceptable dose for chronic non-cancer dose,” Dr. Gus Grant, CEO College of Physicians and Surgeons of Nova Scotia said.
Dr. Grant says the new guidelines also encourage doctors to promote non-opioid therapies. If opioid therapy is needed, physicians are asked to prescribe the lowest effective dosage.
“As far as the CDC is concerned, and we endorse their guidelines, is that we have many patients now on doses of medication that are likely offering more harm than good,” Grant said.
The province’s health minister admits that there is an opiate problem across north america.
“I believe we have to have stronger practices,” Health Minister Leo Glavine said.
“Why should Canada and the U.S. prescribe at a rate of twice what we see in the UK and Scandinavia and countries? So, it’s really time now to have a set of guidelines to adhere to.”
Advocacy group Get Prescription Drugs Off The Streets (GPDOTS) has been calling for changes to how doctors prescribe opiates for years.
“It’s a step in the right direction,” GPDOTS member Tamara Ballard said.
“Patients that are already on these medications they certainly will have a challenge to face in front of them, but for the future generation coming up these guidelines will be very beneficial.”
Direction 180, an organization in Halifax that works with opioid-dependent people, is welcoming the guideline change, but also urging physicians to proceed with caution when reducing prescriptions.
“Those folk that are already prescribed higher doses as they are gradually weaned down over time — some of them maybe have addiction issues, so that may result in injection or snorting of opiates or drug seeking behaviors in other places,” Cindy MacIsaac said.
The hope is that with less opiates being prescribed, the chance of the medications getting into the wrong hands will also decrease.
“I think it’s great news,” MacIssac added. “It’s a very important step in helping to reduce the number of opiates that are on the street.”