EDMONTON – Alberta’s medical regulator wants more stringent rules on how physicians prescribe opioid painkillers and other drugs to improve the safety of patients.
The College of Physicians and Surgeons says next month it will send draft proposals for a standard of practice called “Safe Prescribing” to doctors, the provincial government and others seeking feedback in the hope of approving it next March.
The college notes that opioid prescribing by Alberta doctors is among the highest in the country, and that Canada is one of the top three countries in the world for painkiller use.
READ MORE: Who pops the most painkillers? How Canada’s opioid use compares with the rest of the world
“Data obtained from the Triplicate Prescription Program in 2015 reveals a significant number of Alberta physicians continue to prescribe opioid dosages in excess of the maximum recommended dose in the 2010 Canadian guideline for safe and effective use of opioids for chronic non-cancer pain,” says a memo about the proposed draft standard of practice.
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Some prescription opioids include codeine, morphine, oxycodone and fentanyl patches.
Opioids, including fentanyl and oxycontin, can be prescribed for pain caused by injury, cancer or a chronic condition. It’s common for patients to become tolerant of the drugs, and nearly all patients become physically dependent after daily use for more than several weeks, according to the medical protective association.
The proposed standards would require doctors to prescribe the lowest effective dose to patients who require long-term opioid treatment for chronic pain other than cancer.
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Physicians would have to discuss medication decisions with patients including potential serious side effects, other treatment options and the probability of the drug improving their health.
Doctors would also be required to regularly track a patient’s drug treatment history through Alberta’s pharmaceutical information network.
Dr. Trevor Theman, registrar of Alberta’s college, said they want to move quickly with changes after they hear back from physicians and the government.
“Obviously Alberta and Canada have a huge issue around opioid overuse and misuse,” he said. “Others have called it a crisis, and I think that is a fair characterization.”
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Last March, the U.S. Centers for Disease Control (CDC) released new guidelines to improve the way opioids are prescribed to help reduce the number of people who abuse, misuse or overdose from strong painkilling drugs.
The CDC favours the use of non-opioid drugs for chronic pain, using the lowest possible effective doses of opioids and closer monitoring of patients.
Theman said better drug prescribing rules are just one part of the solution. He said there must be enough alternate treatment programs to help patients who have become dependent on opioids to manage their pain.
READ MORE: Opioids kill hundreds of Canadians a year. Why are doctors still prescribing so many?
“The problem exists right now. Those who are responsible, whether that is Alberta Health Services or the Alberta government or whoever it might be, I think need to take seriously the issue of opioid abuse and opioid use disorder and make it a high priority to ensure that patients and the providers looking after their patients have access to treatment facilities.”
British Columbia’s medical regulator has already moved to deal with what it calls “the public health crisis of prescription drug misuse.”
Last spring the College of Physicians and Surgeons of B.C. approved standards and guidelines for safe prescribing that went into effect on June 1.
Watch Below: Fri, Apr 15: When it comes to drugs and the health emergency declared in British Columbia due to the number of overdoses, one of the root causes behind the spike could be the overuse of prescription drugs. Rumina Daya has more on how big a problem it’s become, and the calls for stronger policies.
Theman said the Alberta college will host a forum next month on how to better address problems with opioid prescribing that will include physicians, Alberta Health, Alberta Health Services and other groups.
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