Doctors develop guidelines to curb opioid misuse

A rise in prescriptions for opioids like OxyContin has spurred a group of Canadian doctors to develop new guidelines to cut back on growing misuse of the drugs.

A rise in prescriptions for opioids like OxyContin has spurred a group of Canadian doctors to develop new guidelines to cut back on growing misuse of the drugs.

Consumption of prescription opioids in Canada jumped 50 per cent between 2000 and 2004, making Canadians the world’s third-largest per capita users of the drugs.

Opioids such as codeine, morphine and oxycodone can be extremely effective in reducing pain, but are also highly addictive.

Misuse of these narcotics can lead to serious injury or death from overdose.

The guidelines are meant to give doctors the tools to prescribe opioids safely and effectively for patients with chronic non-cancer pain who need them.

But it is also aimed at helping physicians to better identify patients who might abuse the drugs.

Dr. Norm Buckley, director of the Pain Management Centre at Hamilton General Hospital, says the new guidelines will help physicians, particularly family doctors, who may have difficulty in deciding when opioids should be prescribed for chronic pain.

“Some patients who are not on opioids should be, and this will help physicians identify and care for them effectively, without sending them to wait months or years for specialty pain clinics,” says Buckley.

The guidelines will also clarify whether some patients may be receiving opioids when they shouldn’t be.

The guide, created by the National Opioid Use Guideline Group, is published in this week’s issue of the Canadian Medical Association Journal (CMAJ) and is also available online at http://nationalpaincentre.mcmaster.ca/opioid.

In a related CMAJ commentary, Dr. Roger Chou writes that more studies of high-risk populations with long-term followup are needed.

“Until these studies are completed, the new Canadian guideline offers clinically sound recommendations for making decisions regarding the use of opioids for treating non-cancer pain,” Chou says.