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Patient Compass

Special Issue: The Opioid Crisis

Advice and Information for Patients

Our quarterly magazine contains important updates on policies, topics of interest, as well as a summary of recent disciplinary findings.
Read the latest issue here.

Like all Canadians, we are deeply concerned about the devastating impact the current opioid crisis is having on patients and communities. As we face escalating opioid overdose deaths across the country and the second highest rate of opioid prescribing/use per capita in the world, we are working with our health care partners on system-wide solutions to ensure patient well-being and public safety.

While there are many factors that have contributed to the opioid crisis, we recognize that well-meaning prescribing by physicians has also contributed to the problem and, therefore, improvements to physicians' prescribing practices must be part of the solution. Prescribing opioids under the right conditions is critical for good patient care and we are taking steps to ensure we give physicians the resources, information and guidance they need to appropriately prescribe opioids to their patients.

In this special issue of Patient Compass, we highlight our Opioid Strategy with particular attention to supports and information for patients and their families.

The CPSO’s Role and Approach: Our Opioid Strategy

Our opioid strategy is grounded in our commitment to improve patient and public safety. The strategy outlines a specific action plan within our legislated area of responsibility with a focus on a four-pronged approach that reflects our mandate to guide, assess, investigate and facilitate education for Ontario’s doctors. The objectives of the strategy are to:

  • facilitate safe and appropriate opioid prescribing by physicians to patients,
  • protect patient access to care, and
  • reduce risk to both patients and the public.

Please take the time to read our Opioid Position Statement for more details on the key activities and elements of the Opioid Strategy and how they will promote appropriate opioid prescribing.

You can also review our fact sheets for highlights of our main activities in each of the four elements of the strategy: Guide, Assess, Investigate and Facilitate Education.

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Are You Currently Using Opioid Therapy?

Some patients currently on opioid therapy may be concerned that our approach could mean that they no longer have access to needed medical treatment. It is very important for you to know that the College is not asking physicians to stop prescribing opioids, but to prescribe responsibly and to stay in line with best practices. We have also told physicians that it is never appropriate to abandon a patient on long-term opioid therapy or to abruptly cut off or threaten to cut off a patient’s medication.

Physicians were previously taught that opioids are effective for treating chronic non-cancer pain without the risk of causing addiction. Recent evidence now tells us that high doses of opioids over long periods may actually worsen patients’ pain over time and can sometimes lead to addiction.

As a result of this new evidence, the new 2017 Canadian opioid prescribing guidelines urge doctors to take a much more conservative approach to prescribing opioids, recommending trying non-opioid treatments first, and prescribing smaller amounts when opioid therapy is considered of potential benefit to a patient. The CPSO’s prescribing drugs policy has been updated to reflect the new guidelines.

If you are on opioid therapy or considering beginning opioid therapy, please read our Message to Patients Living with Chronic Non-Cancer Pain and our FAQ for Patients which will give you and your family some useful guidance and advice regarding opioid therapy.

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Safe Opioid Usage: Find out all you can

If your doctor has recommended that you begin opioid therapy, it is very important that you have enough information to help decide on the best option for you. The most important thing for you to do is talk to your doctor about the risks and benefits of the medication, including the risk of addiction and overdose.

You may also want to do some research on your own. The Institute for Safe Medical Practices (ISMP) has a consumer-focused website that is designed to help patients and caregivers educate themselves about opioid use, benefits and risks. The website has useful patient resources such as:

The ISMP website also has many other interesting articles and information sheets with good advice and tips on safe medication use.

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New CPSO Opioid Web Hub

The CPSO’s new web hub gives patients and their families online access to a wide array of information about opioids and the CPSO’s role in addressing the opioid crisis.

You’ll find easy links to all the information mentioned in this newsletter and more, including:

A section for patients with:

And a section for physicians that includes:

Please visit our opioid webpage to learn all you can about the use of opioids, the current public health crisis, and the work of the College and our health care partners to address this crisis.

Our current issue of Dialogue also includes several articles about opioids and our approach.

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The CPSO’s opioid strategy ensures that we are addressing the opioid crisis by undertaking specific activities that fall within our mandate. Our primary responsibility is always the protection of the public and, in the case of opioids, ensuring that physicians prescribe appropriately and that patients on opioid therapy continue to receive the care they need.

We encourage you to contact the College if you have any questions or concerns. Please call our Public Advisory Service at 1-800-268-7096 ext. 603.

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Current Policy Consultations: We want to hear from you!

Medical Records and Maintaining Appropriate Boundaries

The College regularly conducts public consultations to obtain feedback from the public and physicians on new and revised policies, as well as existing policies that are under review. The feedback we receive helps us to assess policies and determine the issues we should consider throughout the review process.  

We currently have several consultations underway, including:

Medical Records
Our Medical Records policy explains how medical records must be kept and outlines general requirements physicians must follow regarding the collection, use, security, storage, and disclosure of patients’ personal health information for both paper and electronic records. The policy also sets out requirements regarding retention, access and transfer of records, along with the specific information that must be included in records and how it must be documented. 

Maintaining Appropriate Boundaries and Preventing Sexual Abuse
This policy helps physicians understand and comply with the legislative provisions of the Regulated Health Professions Act, 1991 (RHPA) regarding sexual abuse. It sets out the College’s expectations of physicians to maintain appropriate boundaries and not become sexually involved with patients, former patients in certain circumstances, and persons closely associated with patients.

We hope you will take a moment to review each consultation page and share your comments. You can keep up with all current consultations, submit your comments and review all the feedback received by visiting our consultations page.

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We want to hear from you!

The College relies on feedback from the public, as well as the profession, to formulate policy. Please take a few moments to comment on our open consultations.
View our active consultations.
Learn more about the College’s consultation process here.
Join our mailing list and receive notification of all future policy consultations.

For general inquiries or to make a complaint, contact our Public Advisory Service:
Toll Free: 1-800-268-7096 Ext. 603
Copyright © 2017 College of Physicians and Surgeons of Ontario, All rights reserved.

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