The College continues to move forward with implementing initiatives and activities to advance its Opioid Strategy. The Strategy’s objectives are aimed at establishing goals to advance opioid-related education for pharmacy professionals, improve harm reduction strategies and delivery of opioid dependence treatment, prevent overdose and addiction by supporting evidence-based and appropriate dispensing practices, and strengthen oversight of the provision of narcotics and controlled drugs to patients and the security of drug distribution.
In recent months, the College has engaged pharmacy professionals and health system stakeholders in response to the opioid crisis affecting our communities. This work has included:
- Establishing and collaborating with an external working group comprised of pharmacy professionals and other key healthcare stakeholders with expertise in addiction, pain and other specialties. This group provides advice and works with the College to identify tools and resources to support Opioid Strategy-related initiatives.
- Participating on various health system working groups, including the provincial Opioid Emergency Task Force and the Health Quality Ontario Partnered Efforts Table. The Partnered Efforts Table was created to develop a coordinated and integrated approach to support clinicians in the areas of opioid prescribing and pain management and recently released the Ontario Pain Management Resources, a one-stop summary of available pain management supports.
- Collaborating with Health Canada and the Office of Controlled Substances to work toward a common goal of responding to the opioid crisis through the prevention and management of loss and theft of controlled substances, particularly narcotics.
- Pulling together tools and resources on morphine equivalent dosing and tapering. These tools have been reviewed by the external working group and posted on the College’s website.
TOOLS AND RESOURCES RELATED TO MORPHINE EQUIVALENT DOSING AND TAPERING SUPPORTED BY THE COLLEGE’S EXTERNAL OPIOID WORKING GROUP
Opioid Manager
www.opioidmanager.com
Opioid Manager is a point of care tool for healthcare professionals to support them in prescribing and managing opioid use in patients with chronic non-cancer pain. The tools are based on the 2017 Canadian Guidelines for Opioids for Chronic Non-Cancer Pain and are available in a PDF format, an iOS app and in many EMR platforms. The sections include: important considerations for opioid therapy trials, starting an opioid therapy trial, maintenance and monitoring, switching opioids, including a morphine equivalent table, and tapering opioids.
MAGICapp – 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain
https://app.magicapp.org/app#/guideline/2178
MAGICapp is an app version of the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain, including recommendations, evidence summaries and consultation decision aids for practice.
Centres for Disease Control and Prevention (CDC) Opioid Guideline Mobile App
https://www.cdc.gov/drugoverdose/prescribing/app.html
This opioid guideline app is published by the Centers for Disease Control and Prevention in the United States. It reflects the CDC’s Guidelines for Prescribing Opioids for Chronic Pain and includes a morphine milligram equivalent calculator. Available for both android and iOS.
Management of Chronic Non-Cancer Pain Tool
URL no longer available
This tool is designed to assist healthcare professionals in developing and implementing a management plan for adult patients living with chronic non-cancer pain.
Opioids and Chronic Non-Cancer Pain – What Can Pharmacists Do to Better Address Both “Pain” & “Addiction/Diversion” Concerns
www.rxfiles.ca/rxfiles/uploads/documents/Pain-Opioids-Pharmacists-QandA.pdf
A document that provides considerations for pharmacists when interacting with patients who are using opioids. It suggests conversation prompts and actions to be taken when assessing the prescription and counselling patients.
Ontario Pain Management Resources
http://www.hqontario.ca/Quality-Improvement/Guides-Tools-and-Practice-Reports/Primary-Care/Partnered-Supports-for-Helping-Patients-Manage-Pain
Visit this one-stop spot for guidelines on appropriate opioid use, CME-accredited webinars on chronic pain and direct links to medical mentors who can answer your care questions.
Opioid Tapering Template
www.rxfiles.ca/rxfiles/uploads/documents/Opioid-Taper-Template.pdf
This template provides a format for a tapering schedule and includes general approach considerations to tapering off opioids related to chronic non-cancer pain.
OPEN – Deprescribing Algorithm for Benzodiazepines
www.open-pharmacy-research.ca/evidence-based-deprescribing-algorithm-for-benzodiazepines/
There are two tools available for healthcare professionals: a benzodiazepine deprescribing algorithm and a benzodiazepine deprescribing information pamphlet.
Choosing Wisely – Drowsy Without Feeling Lousy
https://choosingwiselycanada.org/perspective/toolkit-benzos-primary-care/
A toolkit for reducing inappropriate use of benzodiazepines and sedative-hypnotics among older adults in primary care, including resources related to achieving consensus on indications, risks and benefits, engaging patients in shared decision making, deprescribing and alternatives.
Have you checked out the latest Pharmacy5in5 module on opioid prescriptions?
This module reviews the assessment of opioids prescriptions and good times to intervene. Topics include acute pain, chronic pain, tapering, switching, side effects and opioid use disorder. Access the module at Pharmacy5in5.ca.
Developed by the University of Waterloo School of Pharmacy, Pharmacy5in5 is an interactive, online and app-based teaching tool that houses self-assessment quizzes and other educational resources. It’s an innovative tool to stay up to date on pharmacy practice, improve your knowledge, and understand pharmacy trends.