VANCOUVER – A new expert report recommends immediate steps to reduce fatal overdoses, addiction and other severe harms related to unsafe prescribing in British Columbia. The province’s four largest private addiction treatment facilities have partnered with over 70 of B.C.’s leading addiction and public health practitioners to endorse the report’s recommendations.
The document, entitled “Together, we can do this: Strategies to address British Columbia’s prescription opioid crisis,” was developed with funding from the B.C. Ministry of Health and the Canadian Institutes of Health Research. It highlights specific areas for intervention with strategies to immediately improve prescribing practices, opioid addiction care, and long-term approaches to increase prescriber knowledge.
“British Columbia has a world leading prescription monitoring system, but it is very worrisome that only approximately one in five physicians use the system,” said Dr. Evan Wood (pictured), Professor of Medicine at the University of British Columbia, Medical Director of Addiction Services at Vancouver Coastal Health and Providence Health Care, and Director of the Urban Health Research Initiative at the BC Centre for Excellence in HIV/AIDS. “This creates major public health concerns that can immediately be addressed if tighter regulations are established to require prescribers and pharmacies to use this simple and quick method to assess safety concerns.”
Administered by the Ministry of Health and the College of Pharmacists of B.C., PharmaNet is a province-wide electronic network that links all B.C. pharmacies, thereby aiming to improve prescription safety.
However, physicians and nurse practitioners in B.C. are not legally required to use PharmaNet even when prescribing high doses of opioids, which could be potentially lethal. This can leave patients and their families vulnerable to overdose from drug interactions when drugs are provided by multiple prescribers, or individuals “doctor shopping” for multiple prescriptions that can be used inappropriately or sold on the street.
“This report adds to work already underway in the Ministry of Health and will help strengthen the strategies in place to reduce fatal overdoses, abuse, addiction and other severe harms related to unsafe opioid prescribing in B.C.,” said Health Minister Terry Lake.
“British Columbia has a system that can ensure adequate access to pain and other medications to those who need them while also protecting patients, their families and the public from unsafe prescribing and abuse,” said Dr. Perry Kendall, B.C.’s provincial health officer and a signatory to the report. “However, to ensure this system is functioning adequately, there are some simple changes that will likely have a major public health benefit with respect to addiction, overdose and other harms by promoting safer prescribing.”
Some of the report’s key recommendations include:
• Requiring all prescribing clinicians to register for PharmaNet and routinely check patients’ PharmaNet profiles when writing prescriptions.
• Putting in place enforcement measures to ensure pharmacies are also routinely checking PharmaNet when dispensing medication.
• Requiring benzodiazepine prescriptions, which are a regular contributor to fatal overdose and addiction, on a duplicate prescription pad (as is currently required for opioid prescriptions in B.C.)
• Implementing a maximum limit for the amount of opioids a patient may be given at once.
• Dedicating investments into evidence-based addiction treatment to improve care of opioid addicted patients and their families.
The report is supported by the B.C. government which has taken a leadership position by investing in the improvement of addiction care through the support of initiatives that aim to increase the number of skilled addiction physicians as well as strategies to prevent and treat addiction.
This includes a $3-million investment announced by the Government of B.C. in August 2014, which supports new ways to treat substance dependence and the establishment of a new provincial addiction network.
About the Urban Health Research Initiative
The Urban Health Research Initiative (UHRI) is an innovative research program based on a network of studies developed to help identify and understand the many factors that affect the health of urban populations. Focusing primarily on issues relating to substance abuse, infectious diseases, the urban environment and homelessness, UHRI aims to improve the health of individuals and communities through research to inform policy. Founded in 2007, UHRI’s team consists of researchers, epidemiologists, statisticians, ethnographers, research assistants, research coordinators, registered nurses, knowledge translations coordinators, students, and support staff.
About the British Columbia Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including government, health authorities, healthcare providers, academics from other institutions. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians.