Canadian doctors should try to avoid prescribing opioids: experts

Bill Graveland, The Canadian Press


Published Monday, November 13, 2017 5:26PM EST

An interim report released at a pain management conference suggests the best way to cut down on opioid addiction is to not prescribe the drugs in the first place.

Michael Heitshu, chairman of the Coalition for Safe and Effective Pain Management, says a lack of affordable alternatives for pain relief in Canada is partly behind an over-reliance on opioids and rising addiction rates.

“Canada is the second-leading consumer of opioids in the world and it doesn’t have to be. What the coalition is doing is looking … at why opioids are being prescribed and what could be done to reduce the prevalence of opioid prescribing,” Heitshu said Monday in Calgary.

“Given the human and financial costs of the opioid crisis, Canada needs a better approach to pain management.”

Heitshu said over 19 million prescriptions were written for opioids in Canada last year.

A federal government report said there were 2,458 apparent opioid-related deaths in the country in 2016 — a rate of 8.8 per 100,000 population. The numbers were worse in Western Canada with apparent opioid-related death rates of more than 10 per 100,000 population for Yukon, Northwest Territories, British Columbia and Alberta.

“The strong growth of opioid prescribing in Canada has been for quite common pain conditions like back pain, arthritis and chronic pain. These are actually conditions where opioids aren’t that effective and where the risks are tremendous,” Heitshu said.

“A surprisingly high proportion of people who end up in trouble start with a legitimate prescription and following their doctors orders. We now know that the risk of dependency can start three to five days after opioids are first prescribed.”

The report suggests doctors recommend alternative therapies such as psychological treatments, physio and occupational therapy, and chiropractic care.

The 10-member coalition includes the Canadian Association of Occupational Therapists, Canadian Centre on Substance Use and Addiction, Canadian Chiropractic Association, Canadian Nurses Association, the Canadian Physiotherapy Association and Canadian Psychological Association.

“We would also like to see better collaboration between patients and front-line health providers when making decisions about how to safely manage their pain. It is important that Canadians know that these alternatives exist and are asking important questions,” said Chris Power from the Canadian Patient Safety Institute.

Heitshu said it’s time for doctors to put down their prescription pads when it comes to opioids except as a last resort.

The study recommends provincial and federal governments consider adding alternative medicine to public health-care coverage.

A final report from the coalition is expected next year.


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