B.C. doctors told not to limit opioids or refuse care of chronic pain patients

College of Physicians and Surgeons of B.C. updated its standard of practice for prescribing opioids

The college that oversees doctors across the B.C. has updated its guidelines for prescription opioids, now requiring doctors to prescribe certain drugs and sedatives to those suffering from chronic pain without limiting dosage or refusing to see the patient.

The revisions by the College of Physicians and Surgeons of B.C. will be sent to doctors this week, said college registrar Dr. Heidi Oetter, following months of draft revisions and consultations with both doctors and the public.

The original college guidelines came to fruition in 2016, before any national guidelines existed in Canada, as B.C. saw a drastic uptick in illicit drug overdoses. Officials turned to over-prescribing at doctors clinics as one facet of the overdose spikes. Since then, the province has led the way in some of the highest death tolls due to the powerful illicit drug fentanyl.

READ MORE: 391 people died of illicit drug overdose in B.C. from January to March

READ MORE: Naloxone prevented 26% of possible overdose deaths in B.C.

READ MORE: More than 1,400 people in B.C. died of drug overdoses in 2017

But as the guidelines looked to tide what has become an epidemic in the province, those suffering from chronic pain were concerned their level of care would be impacted.

Complaints received by the college were mixed, with some people who felt they weren’t getting the prescription they needed and others who alleged cases of over-prescribing, Oetter said. The college is hoping the updated standard of care clears up misconceptions doctors may have.

Now, when physicians are prescribing doses of opioids higher than 90 mg of morphine equivalent, they have to document evidence of the need, Oetter said, but cannot refuse care.

“We really wanted to make it front and centre that it was unacceptable for physicians to refuse to see – or fire – patients, or exclude from taking on patients who were either on opioids or had a history of using opioids, because that simply is discrimination and that is not acceptable,” Oetter said.

The prescription practices do not apply to cancer patients, or those in end-of-life care, Oetter said, nor those who are seeking treatment for substance use disorder. “Some physicians were thinking it applied to them and it clearly doesn’t,” she said.

Opioid prescribing for patients of acute-pain, such as after surgeries or accidents, is also not included in the updated standard of care. Oetter said the college is looking forward to findings compiled by the DeGroote School of Medicine at McMaster University on safety and public policy measures that can be taken in the future.

College reinforces tapering of opioid prescriptions on trial basis

Doctors having to document and record why they are prescribing opioids is included in the new standard so doctors can both confidently prescribe powerful pain medications, but also reasses whether the patient is truly benefiting from high doses over time.

Oetter said doctors can look to modern studies that show physiotherapy, weight management and other non-drug related options have proven to be positive for patients.

“The emerging evidence says that patients don’t necessarily do better when they are on more [drugs],” Oetter said.

For many decades, physicians were told long-term opioid therapy was safe and that there was no need to consider limiting dosage, Oetter said, but new evidence is reigning that in and recommending doctors instead work with patients to taper opioid prescriptions while recognizing is often trial attempts and continuous follow up.

“The tides are turning a bit,” she said. “Patient-centred care really needs to balance the risks with the potential benefits and all other treatment options really need to be considered for the patient.”

College of Physicians and Surgeons of British Columbia: Safe Prescribing of Opioids by Ashley Wadhwani on Scribd


@ashwadhwani
ashley.wadhwani@bpdigital.ca

Like us on Facebook and follow us on Twitter.

Just Posted

Festival planned for Easter weekend

Organizers preparing 10,000 eggs for hunt at Summerland’s Easter Egg-stravaganza

Behind the mask of the South Okanagan furries community

Penticton furries community member said it’s not a sexual thing

Summerland experiences effects of sudden warm temperatures

Water pools near sports fields; minor landslide affects Garnet Valley Road as snow melts

Crown drops one Vernon assault charge against Curtis Sagmoen

Curtis Wayne Sagmoen will still stand trial on one count of assault causing bodily harm in December.

COLUMN: Awaiting the signs of spring

After a long winter, many are wondering when the cold season will be over

VIDEO: Restaurant robots are already in Canada

Robo Sushi in Toronto has waist-high robots that guide patrons to empty seats

Permit rejected to bring two cheetahs to B.C.

Earl Pfeifer owns two cheetahs, one of which escaped in December 2015

Real-life tsunami threat in Port Alberni prompts evacuation updates

UBC study says some people didn’t recognize the emergency signal

Care providers call for B.C. seniors’ watchdog to step down

The association also asks the province to conduct an audit and review of the mandate of her office

Update: Highway 3 near Keremeos open to alternating traffic

Details scarce about collision that has closed Highway 3 west of Keremeos

Okanagan librarian delves into trio of titles

Book Talk: Dark Matter, Lincoln’s Dreams and The Jealous Kind

Nitro Cold Brew Coffee from B.C. roaster recalled due to botulism scare

“If you purchased N7 Nitro Cold Brew Coffee from Cherry Hill … do not drink it.”

B.C. man gets award for thwarting theft, sexual assault – all in 10 minutes

Karl Dey helped the VPD take down a violent sex offender

Indigenous students recognized at ceremony at Okanagan College

The ceremony recognizes that students are getting an education while holding onto Indigenous background and teachings

Most Read