It goes without saying that the opioid crisis is high up on everyone’s radar screen. Moving ahead from laying blame, we are left to try and manage this crisis and gather all the resources that will help address pain treatment and dealing with opioid and substance abuse.
So it is timely that Choosing Wisely Canada has launched
, a campaign that “encourages thoughtful conversation between clinicians and patients to reduce harms associated with opioid prescribing.” It was launched on March 1, 2018 with the support of over 30 participating organizations representing doctors, dentists, pharmacists, nurse practitioners, other health professionals, as well as patients and their families. Central to the campaign is a set of 14 specialty-specific recommendations.
Visit the Opioid Wisely page for a full listing of all recommendations (access this link through our Quick Links section).
One highlight from
recommendations (recommendation #12 -find this one and more in our Quick Link section) from the College of Family Physicians of Canada:
Don’t continue opioid analgesia beyond the immediate postoperative period or other episode of acute, severe pain.
"The immediate postoperative period or acute episodes of pain typically refers to a time period of three days or less, and rarely more than seven days. Prescribe the lowest effective dose and number of doses required to address the expected pain. This recommendation does not apply to individuals already on long term or chronic opioids or opioid agonist treatment."
This is especially pertinent in view of the first actual study of opioids vs. nonopioids for chronic pain, an RCT published in the Journal of the American Medicine Assocation, which concluded that "Treatment with opioids was not superior to treatment with nonopioid medications for improving pain-related function over 12 months. Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain." Visit our Quick Links section for the full article.
In the coming weeks, our aim is to provide more resources and tools, including some exciting news in Addiction Medicine in Hamilton.