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In an effort to curb misuse of opioids and stop overdose deaths, the Faculty of Physicians and Surgeons of British Columbia launched a legally enforceable follow commonplace, “Safe Prescribing of Drugs with Potential for Misuse/Diversion,” in 2016. This doc restricted the prescribing of opioids for continual noncancer ache (CNCP) with particular prescribing practices that clinicians had been obligated to observe.
In analysis that examined the results of the 2016 follow 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 traits 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 properly, the variety of sufferers who had doses aggressively tapered elevated, which may end up in improper ache administration.
The evaluation included knowledge on all opioid prescriptions allotted to community-living adults in BC between October 2012 and March 2020.
“This demonstrates the ability of practice standards to modify physician behavior but also highlights how misinterpretation can harm patients,” writes Dr. Dimitra Panagiotoglou, affiliate professor at McGill College, Montréal, Quebec, with co-authors. “Patient groups and physicians affected by standards or guidelines should be consulted before their release to reduce unintended consequences.”
When the 2016 follow commonplace was changed in 2018, the downward traits slowed.
“These findings demonstrate that prescribing guidelines and practice standards can have immediate and long-lasting effects on physician prescribing. Although most of the changes may be positive (e.g., fewer opioids in the community, a reduction in coprescribed benzodiazepine), incorrect interpretation can increase harms for some patients. Aggressive tapering can have downstream consequences, including people resorting to unregulated opioids for pain relief despite their risks,” write the authors.
Folks dwelling with continual ache and opioid use dysfunction (OUD) in Canada are sometimes unable to entry evidence-based remedy, which might cut back the effectiveness of therapies for OUD, in keeping with a commentary in the identical situation.
“Overcoming barriers—such as siloed care for OUD and chronic pain, and restricted access to allied health services that can improve pain management and OUD outcomes—is essential to effectively addressing the needs of patients with comorbid OUD and chronic pain,” 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 counsel interdisciplinary approaches, akin to together with ache administration specialists in care, may assist enhance outcomes for individuals with continual 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 continual ache administration into look after sufferers with opioid use dysfunction. Canadian Medical Affiliation Journal (2025) . DOI: 10.1503/cmaj.241320
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Canadian Medical Affiliation Journal
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Opioid prescribing requirements modified practices in British Columbia, however with caveats (2025, Might 12)
retrieved 12 Might 2025
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