Dear colleague,

What’s your role with respect to opioid safety? Have you considered this question?

One of the core functions of our Royal College is to connect you with evidence-based information and learning materials to help you in your work.

If you are a specialist who prescribes opioids within your scope of practice, you have a particular responsibility to ensure that you are prescribing safely.

We can all benefit from up-to-date knowledge on the benefits and risks of opioid prescriptions, and encourage our patients to be informed on their medication use.


The numbers are telling:

  • About 15%-29% of Canadians experience chronic pain (Fischer & Argento, 2012).
  • Canada is known as the second largest consumer per capita of prescription opioids (International Narcotics Control Board, 2013).
  • In 2012, 18.3 million opioid prescriptions were dispensed in Canada. In 2014, that figure jumped 18.6% to 21.7 million (Fischer & Argento, 2012).
  • Opioid-related deaths in Canada doubled from 1991 to 2004 (Dhalla et al., 2009).

The Royal College has newly-released a Statement of Principles on Opioid Use. I encourage you to read it. While only 2 pages, it outlines the principles underlying our response to the opioid crisis this country is facing.

Some examples,

  • Patient experience and outcomes: Patients should gain the optimal benefit from opioids and other pharmacological interventions to achieve effective pain management while minimizing poor outcomes (i.e. hyperalgesia, myoclonus) and adverse events (i.e. unintended overdoses, self-medication).
  • Promoting safe practice: [We will] support the implementation of strategies and approaches that reduce harm, diminish variability in prescribing practices, enable appropriate assessments of patients and reduce preventable deaths from opioid medication.
  • Access to real-time, technological resources and supports: Physicians require real-time, point of care access to educational resources to inform their prescribing treatment decisions. These tools must be relevant to the specialist’s scope of practice (including clinical setting and patient population needs).

See the full document [PDF].

On that last point, I’m pleased to share with you the first wave of resources to help you in your treatment decisions. These reference materials (related to pain management and safer opioid prescribing practices) were sourced nationally and globally in consultation with relevant Royal College committees and partner-experts across Canada

I hope you will take the time to review this collection and to share these resources with your colleagues. I also hope that you will take me up on my request that you tell us if these resources are useful to you and/or your ideas for how we can continue to (or better) assist you with training and education on this essential practice parameter.

Please feel free to add your comments below, send me an email (ceo@royalcollege.ca) or contact our health policy team directly (healthpolicy@royalcollege.ca).

You can also visit our Safer Opioids webpage if you’re interested in knowing more about our activities in this domain – either past or planned.

Sincerely,

Andrew Padmos, BA, MD, FRCPC, FACP

Chief Executive Officer