In an effort to curb misuse of opioids and forestall overdose deaths, the School of Physicians and Surgeons of British Columbia launched a legally enforceable apply commonplace, “Protected Prescribing of Medication with Potential for Misuse/Diversion,” in 2016. This doc restricted the prescribing of opioids for persistent noncancer ache (CNCP) with particular prescribing practices that clinicians had been obligated to comply with.
In analysis that examined the consequences of the 2016 apply commonplace on prescribing to sufferers with CNCP, researchers discovered that its introduction had a marked influence on prescribing practices.
The findings have been revealed within the Canadian Medical Affiliation Journal.
Pre-existing declining developments in doses of opioids (measured in morphine milligram equivalents) accelerated, as did declines in high-dose prescribing, coprescribing with hypnotics like benzodiazepines, and prescribing bigger provides of medicines. As nicely, the variety of sufferers who had doses aggressively tapered elevated, which may end up in improper ache administration.
The evaluation included information on all opioid prescriptions allotted to community-living adults in BC between October 2012 and March 2020.
“This demonstrates the flexibility of apply requirements to change doctor conduct but in addition highlights how misinterpretation can hurt sufferers,” writes Dr. Dimitra Panagiotoglou, affiliate professor at McGill College, Montréal, Quebec, with co-authors. “Affected person teams and physicians affected by requirements or tips needs to be consulted earlier than their launch to scale back unintended penalties.”
When the 2016 apply commonplace was changed in 2018, the downward developments slowed.
“These findings exhibit that prescribing tips and apply requirements can have quick and long-lasting results on doctor prescribing. Though a lot of the modifications could also be constructive (e.g., fewer opioids in the neighborhood, a discount in coprescribed benzodiazepine), incorrect interpretation can enhance harms for some sufferers. Aggressive tapering can have downstream penalties, together with individuals resorting to unregulated opioids for ache reduction regardless of their dangers,” write the authors.
Folks dwelling with persistent ache and opioid use dysfunction (OUD) in Canada are sometimes unable to entry evidence-based therapy, which may scale back the effectiveness of therapies for OUD, in response to a commentary in the identical difficulty.
“Overcoming limitations—akin to siloed look after OUD and persistent ache, and restricted entry to allied well being companies that may enhance ache administration and OUD outcomes—is crucial to successfully addressing the wants of sufferers with comorbid OUD and persistent ache,” writes Dr. Kiran Grant with co-authors, in a associated commentary. Dr. Grant is an emergency medication resident on the College of British Columbia, Vancouver, BC.
They recommend interdisciplinary approaches, akin to together with ache administration specialists in care, might assist enhance outcomes for individuals with persistent ache and OUD.
Extra info:
The results of a provincial opioid prescribing commonplace on prescribing for ache in adults: an interrupted time-series evaluation, Canadian Medical Affiliation Journal (2025). DOI: 10.1503/cmaj.250167
Kiran Grant et al. Commentary: Integrating persistent ache administration into look after sufferers with opioid use dysfunction. Canadian Medical Affiliation Journal (2025) . DOI: 10.1503/cmaj.241320
Quotation:
Opioid prescribing requirements modified practices in British Columbia, however with caveats (2025, Might 12)
retrieved 12 Might 2025
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