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Tackling opioid use disorder on the frontlines

Evidence-based treatment can improve the lives of those living with an opioid use disorder

…so begins a report prepared by the Canadian Centre on Substance Use and Addiction (CCSA) last year documenting the many best practices in use across the country to manage a condition inexorably linked to the explosion of opioid-related deaths.

The Public Health Agency of Canada estimated 10,300 Canadians died from opioid-related causes between January 2016 and September 2018. More than 100 Ontarians are dying of an opioid overdose each month, and the crisis is not yet slowing. It is clear that we have an evidence-based consensus that more can and should be done to support those working on the front-lines of our health care system—family physician offices, nurse practitioner led clinics, and emergency departments, for example.

Counting on surgical teams

When it comes to taking opioids for the first time, it is not surprising that this frequently occurs after having surgery.

Opioids have become the go-to class of medications for controlling pain and after surgery, many patients require drugs to help deal with pain as they recover from a procedure. This has been documented in a major report by Health Quality Ontario released in 2017 – showing that surgeries are second only to dentists’ offices for the percentage of opioids prescribed to patients who had never used opioids before.

Now, 47 hospitals in Ontario who are part of the Ontario Surgical Quality Improvement Network have launched a campaign to reduce the quantity of opioids that surgical teams prescribe after surgery. These hospitals are responsible for almost 80% of the surgical operations that take place in the province annually.

MyPractice: My Primary Care

Dr. David Kaplan

According to a recent report from Health Quality Ontario, 9 Million Prescriptions, one in seven Ontarians fills a prescription for opioids every year. More than 9 million prescriptions for opioids were filled in the province in 2015/16. Canada remains the second-largest consumer of prescription opioids in the world, after the US.

Unfortunately, many patients are receiving these highly addictive drugs, from both legitimate and illicit sources, with only questionable benefit. This is a complex problem involving many health care providers and many interwoven factors compounding the situation.

While physicians are faced with the challenges of treating patients with often complex disorders and few resources, more appropriate prescribing by all physicians is part of the solution.

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