News Release

Ensuring Safe Opioid Prescribing

Statement from CPSO president, Dr. Joel Kirsh

Nov 03, 2016

The College of Physicians and Surgeons of Ontario is committed to enhancing quality medical care and ensuring public safety. In order to accomplish these goals, the College conducts comprehensive and timely investigations of Ontario physicians when concerns are raised.

It is vital that we conduct, and be seen to conduct, impartial investigations. When investigating, we operate under strict confidentiality provisions under our governing legislation. Consequently, while we can confirm we are investigating some physicians related to opioid prescribing, we are not able to provide information about active investigations. When we receive information from the provincial government’s Narcotics Monitoring System, or another source, that suggests a physician has prescribed extremely high daily doses of opioids to multiple patients over extended periods of time (for example, 650 milligrams of morphine per day and the equivalent of 20,000 milligrams of morphine for a patient at one time), we will consider the accuracy of the information, and the clinical context in which the prescribing occurs. Where an investigation is warranted, it will include seeking more information from the prescribing physician and others in order to better understand and evaluate the prescribing.

Understanding and questioning prescribing practices is not intended to discourage appropriate opioid prescribing, and we stress that it is our expectation that physicians who are the subject of an investigation will not suddenly cease prescribing to patients currently on opioid therapy as such an act would not be good medical care. We have provided physicians with resources and guidance in our Dialogue magazine and on our website respecting safe and effective prescribing, and tapering protocols, when clinically indicated.

Prescribing opioids under the right conditions is critical for good patient care and our goal is to ensure that physicians have the resources and information they need to safely and appropriately prescribe opioids to their patients. Equally important is that we effectively address unsafe prescribing practices and reduce the risks that such practices pose to patients and the community.