An organizer displays a naloxone kit that people can pick up for free as International Overdose Awareness Day training seminar takes place at Centennial Square in Victoria, B.C., on Saturday August 31, 2019. THE CANADIAN PRESS/Chad Hipolito

An organizer displays a naloxone kit that people can pick up for free as International Overdose Awareness Day training seminar takes place at Centennial Square in Victoria, B.C., on Saturday August 31, 2019. THE CANADIAN PRESS/Chad Hipolito

Fewer people prescribed opioids in B.C., but other provinces lack data: doctors

Patients who began taking opioids were prescribed smaller doses for shorter duration

Fewer people in British Columbia, Saskatchewan and Ontario were prescribed opioids last year compared with 2013 and the number of patients who began treatment on the pain medication decreased by nearly 10 per cent, the Canadian Institute for Health Information says.

The institute said in a report released Thursday that eight per cent fewer patients, or about 220,000 people, in those provinces are taking prescription opioids while approximately 175,000 fewer people were started on the drugs.

Patients who began taking opioids were prescribed smaller doses for shorter duration and when it came to long-term opioid therapy, fewer people were prescribed the medication for a period of 90 days or longer before sometimes being switched to other types of drugs to manage pain, the agency said.

It said initiatives including national prescribing guidelines introduced in 2017, along with prescription-monitoring programs to help reduce harms related to the overdose crisis, likely influenced prescribing trends.

“Despite overall decreasing trends in the prescribing of opioids, opioid-related harms and deaths have continued to rise across the country in recent years,” the report says.

Michael Gaucher, director of pharmaceuticals for the agency, said only the three provinces provided complete data for opioid prescribing for the six years covered in the report but they represent a large portion of Canada’s population.

Some chronic-pain patients have been concerned about being cut off opioids they need, and Gaucher said that is a valid issue to consider because opioids are an effective treatment.

“The concern with prescription opioids goes deeper than the person (taking them) and there can be others in the household that can access them,” he said.

Dr. Norman Buckley, scientific director of the Michael G. DeGroote Institute for Pain Research and Care at McMaster University, said “it’s unfortunate” that data for Quebec and Alberta, for example, could not be included in the report.

He said doctors in Quebec generally prescribe fewer opioids than other provinces and are known for getting a substantial amount of education on pain management while physicians in Alberta and B.C., have access to real-time prescription-monitoring systems for patients.

“You could make the argument that having a concerted pain strategy actually also leads to less reliance on opioids,” he said from Hamilton.

READ MORE: Fatal overdoses down by 33% in B.C., but carfentanil deaths on the rise

Buckley, who often treats pain patients referred to him by other doctors, said it’s important for patients to know they need to be tapered off opioids slowly.

“It’s about correct prescribing or optimal prescribing rather than trying to drive the dose down. What you need to be looking at are things like measures of function, and those typically don’t come through on large-scale administrative health data,” he said.

“You can’t tell, if people’s doses came down, did they stop going to work, for example, or did they start relying on more assistance for home care?”

Buckley said one of his patients, a man in his late 50s, had been prescribed opioids for 10 years due to a variety of workplace injuries but decided to taper off due to his concerns about long-term use.

His dosage was gradually reduced over a year and a half, Buckley said, adding his pain wasn’t any better but his “mental energy” improved somewhat.

“He also finds he’s edgier than he was so his wife has been in once or twice to say, ‘Look, he gets grumpy a lot more than he used to but he’s probably a bit more mentally active.’ “

The patient also received physical therapy, one of the ways the national guidelines advise doctors to treat pain beyond opioids, but many provinces don’t cover such costs, Buckley said.

“A lot of people don’t have that. This is one of the push-pull parts (of the issue). Optimal pain management includes more than medications. It includes education, sometimes cognitive behavioural therapy and exercise. But a significant portion of the country can’t access those through their provincial health-care systems.”

Buckley suggested all provinces provide complete opioid prescribing data to the Canadian Institute for Health Information so a fuller picture of what’s happening across the country is available.

READ MORE: Alberta to join B.C.’s class-action lawsuit against opioid manufacturers, distributors

Camille Bains, The Canadian Press


Like us on Facebook and follow us on Twitter.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

A&W on Ryan Road confirmed a positive case of COVID-19 at their restaurant and temporarily shut its doors. Google Maps photo
Courtenay restaurant temporarily closed due to COVID-19 exposure

It’s the latest business in the Valley to be affected by the virus

The CSRHD board moved closer to passing a budget with a $4.4 million cut to the tax requisition. Photo by Mike Chouinard
Comox Strathcona hospital district moves on budget with tax cut

At $12.6 million, budget requisition represents drop of $4.4 million for current year

Courtenay councillor Will Cole-Hamilton, standing at right, sits on steering committees of two organizations that are tackling the problem of greenhouse gas emissions. File photo
Courtenay councillor leads campaign to reduce building-sector GHG emissions

Courtenay councillor Will Cole-Hamilton wants local governments to carry a little more… Continue reading

A rendering shows the entrance planned for the Hornby Island Arts Centre. Image supplied
Numerous Comox Valley projects get CERIP grants

Numerous Comox Valley projects have received grants through the Community Economic Recovery… Continue reading

Thrifty Foods. (Black Press file photo)
Thrifty Foods confirms staff member tests positive for COVID-19 in Courtenay

The company currently lists 12 stores within B.C. with confirmed cases

Provincial health officer Dr. Bonnie Henry updates B.C.’s COVID-19 situation at the B.C. legislature. (B.C. government)
B.C. reports 10 additional deaths, 395 new COVID-19 cases

The majority of new coronavirus infections were in the Fraser Health region

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

Site C will go ahead, one year later and $5.3 billion more, the NDP announced Feb 26. (BC Hydro image)
B.C. NDP announces Site C will go ahead with new $16B budget

Reviews recommend more oversight, beefed up foundation stability work

Shannon Davis, manager at Sidney’s Star Cinema, holds up the largest available bag of popcorn available for sale at the theatre. It also also sells four smaller sizes in generating revenue following its closure last fall because of COVID-19. (Wolf Depner/News Staff)
Vancouver Island theatre can’t give you movies, but it can serve popcorn

Sidney’s Star Cinema using popcorn sales to prop up COVID-plagued bottom line

The BC Prosecution Service announced last year that it was appointing lawyer Marilyn Sandford as a special prosecutor to review the case, following media inquiries about disclosure issues linked to a pathologist involved in the matter. (Black Press Media files)
Possible miscarriage of justice in B.C. woman’s conviction in toddler drowning: prosecutor

Tammy Bouvette was originally charged with second-degree murder but pleaded guilty in 2013 to the lesser charge

A kid in elementary school wearing a face mask amid the COVID-19 pandemic. (Metro Creative)
Union asks why an elementary school mask rule wouldn’t work in B.C. if it does elsewhere

B.C. education minister announced expansion of mask-wearing rules in middle, high school but not elementary students

A pharmacist prepares a COVID-19 vaccine at Village Green Retirement Campus in Federal Way on Jan. 26. (Olivia Sullivan/Sound Publishing)
Canada approves use of AstraZeneca’s COVID-19 vaccine

The country joins more than a dozen others in giving the shot the green light

Nanaimo Ladysmith Public Schools is preparing a rapid response team proposal for submission to the B.C. Ministry of Education. (Chris Bush/News Bulletin)
Nanaimo school district chosen as Vancouver Island’s COVID-19 rapid response team

Team to consist of SD68 and Island Health staff, according to B.C. Ministry of Education

A new survey has found that virtual visits are British Columbian’s preferred way to see the doctor amid the COVID-19 pandemic. (Unsplash)
Majority of British Columbians now prefer routine virtual doctor’s visits: study

More than 82% feel virtual health options reduce wait times, 64% think they lead to better health

Most Read