Appropriate Opioid Prescribing

Illustration of prescription drugs

Canada is in the midst of an opioid crisis, with escalating overdose deaths in multiple provinces and the second highest rate of opioid prescribing/use per capita in the world. Like all health-care regulators around the globe, we are deeply concerned about the devastating impact on patients and communities.

While prescription opioids are an important and useful therapeutic tool for select patients with certain conditions, prescription opioids carry risks, even when prescribed and used appropriately. Addressing the opioid crisis requires health-system-wide solutions and collaboration amongst government agencies, health-care educators, regulators, physicians and other health professionals to ensure patient well-being and public safety.

The College has developed a strategy that identifies and commits us to a specific action plan within our area of responsibility of medical regulation and is grounded in our steadfast commitment to improved patient and public safety.

CPSO Opioid Strategy

The College’s Opioid Strategy comprises a four-pronged approach reflecting our mandate, namely to: Guide; Assess; Investigate; and Facilitate Education for Ontario’s doctors. The strategy is supported through effective communication and collaboration with physicians, the public and health-system partners, and using data and analytics to inform prescribing practices and our regulatory responsibilities.

The objectives of the College’s Opioid 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.

The College’s Opioid Position Statement outlines the key College activities and elements of our Opioid Strategy which promote appropriate opioid prescribing, and highlights the complementary roles of system partners. Our fact sheets highlight our main activities in each of the four elements of the strategy: Guide, Assess, Investigate and Facilitate Education.

For patients living with chronic non-cancer pain

Physicians want to relieve pain, and 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.

The CPSO recognizes that well-meaning overprescribing has contributed to the opioid problem, and that individual doctors and the medical profession as a whole must be part of the solution. The 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain urges doctors to take a much more conservative approach to prescribing opioids and recommends trying non-opioid approaches to treatment first, and when opioids are appropriate for your pain, smaller amounts should be prescribed.

If you are a patient on or considering opioid therapy, please read our Message to Patients Living with Chronic Non-Cancer Pain and our FAQ for useful guidance for patients and their families.

Articles from Dialogue magazineCover of Dialogue magazine featuring opioids

Throughout 2016 and 2017, we published a number of articles on opioids in our quarterly magazine, Dialogue, which is distributed to all licensed physicians in Ontario. Click on the links below to read these articles online.

Volume 14, Issue 1, 2018

Volume 13, Issue 4, 2017

Volume 13, Issue 3, 2017

Volume 13, Issue 2, 2017

Volume 13, Issue 1, 2017

Volume 12, Issue 4, 2016

Volume 12, Issue 3, 2016

Volume 12, Issue 2, 2016

Volume 12, Issue 1, 2016