In the Fall 2017 issue of Pharmacy Connection, the College published its Opioid Strategy. The strategy focuses on four strategic priorities, which all have an emphasis on reducing opioid use disorder and preventing overdose and addiction, and is in support of efforts by governments and other health system stakeholders.
With the overall strategy in place, the College has been busy confirming, reviewing and developing work plans for specific key initiatives that support each priority.
OPIOID STRATEGY EXTERNAL WORKING GROUP
In order to support and advise on the development of specific initiatives under the strategy, the College has created an external working group. This group is comprised of pharmacy professionals with expertise in addiction, pain and other specialties, in addition to other key healthcare stakeholders. To gather participants, the College invited applications through e-Connect. Almost 200 pharmacy professionals submitted an application evidence of how engaged and motivated the pharmacy profession is to take action on the opioid crisis. It is anticipated that the first meeting will take place in March.
Those who were not chosen for the working group will form a special practice community that will support the opioid strategy by reviewing and providing feedback on tools, resources and policies for the College on an occasional basis.
COLLABORATION
There are many external groups working to address opioid-related harms. Recognizing that collaboration can more effectively address shared goals, representatives from the College participate in many of these groups, including:
- The Provincial Opioid Emergency Task Force, which brings together many partners to strengthen the province’s response to the opioid crisis.
- CAMH’s opioid-related committees, including the Opioid Internal Network, which ensures alignment and coordination of CAMH opioid-related initiatives and activities and the Opioid Dependence Treatment Advisory Committee, which informs the enhancement of the Opioid Use Disorder Treatment Certificate Program.
- NAPRA’s opioid-related working groups, which were established to meet NAPRA commitments identified in the Joint Statement of Action to Address the Opioid Crisis.
- The Prescription Monitoring Leadership Roundtable, which ensures that the narcotic monitoring system (NMS) data is used by the ministry in a consistent and evidence-based manner, helping to identify potentially inappropriate prescribing and dispensing practices.
The College is also engaged in other collaborative efforts with Health Quality Ontario, as well as participating in the Ministry of Health and Long Term Care’s monthly opioid health system coordination call.
THE OPIOID CRISIS IN NUMBERS
HIGHLIGHTING KEY ACTIONS IDENTIFIED UNDER THE STRATEGY
Supporting the strategy and the four priorities are a number of specific initiatives and actions that are being taken by the College, including:
- Developing an opioid treatment policy, which will support the application of standards and the implementation of best practices including expectations regarding opioid dispensing and security.
- Working with the University of Waterloo to develop an opioid module for Pharmacy5in5.
- Identifying a set of pharmacist-centric morphine equivalent dosing (MED) tools.
- Building stronger expectations into the self-assessment process regarding continuing education related to opioids.
- Developing and implementing a pharmacist-patient communication tool that will provide guidance to pharmacists on how to have difficult conversations with patients regarding opioid use.
- Developing tools to support improved documentation, monitoring and follow-up of patients with chronic pain in close alignment with Health Quality Ontario’s Quality Standard for Opioid Prescribing for Chronic Pain.
- Engaging government in discussions regarding the need for access to electronic health records and system-wide data analysis.
- Working with stakeholders to address opioid security and enhance public protection, for example reducing loss and diversion from pharmacies and using existing data (e.g. NMS, narcotic loss reporting) to identify substandard practices.
The College regularly adds tools and resources to its website regarding opioid-related issues, including to the Opioids Practice Tool, the Narcotics Practice Tool and the Opioids Continuing Education Listings. Pharmacy professionals are encouraged to review these pages frequently. A recently added tool is the OPA’s Pharmacist Clinical Tool for Initiating Naloxone Discussions: a conversation tree, providing prompts and guidance for pharmacists on how they can engage patients or their caregivers in discussions about naloxone. It also includes a checklist to help identify patients at the highest risk of opioid-related respiratory depression.
- Government of Ontario. Ontario Expanding Opioid Response as Crisis Grows. Retrieved at: https://news.ontario.ca/mohltc/en/2017/12/ontario-expanding-opioid-response-as-crisis-grows.html
- Public Health Agency of Canada. National report: Apparent opioid-related deaths. Retrieved at: https://www.canada.ca/en/public-health/services/publications/healthy-living/apparent-opioid-related-deaths-report-2016-2017-december.html