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College Endorses New Canadian Guideline for Opioid Prescribing

At its May 26 meeting, the Council of the College of Physicians and Surgeons of Nova Scotia endorsed the new 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain as best practices for physicians in Nova Scotia.

“The guidelines reflect the most current scientific evidence available in treating chronic non-cancer pain. The evidence concludes that high doses of opioids over long periods of time pose serious risks to patients including opioid dependency, addiction and overdose,” said Dr. Gus Grant, Registrar and CEO of the College of Physicians and Surgeons of Nova Scotia.

Dr. Grant is one of the authors of the new guidelines released by the National Pain Centre at McMaster University which lays out ten recommendations for physicians prescribing opioids. The authors’ number one recommendation is that opioids should not be the first line of therapy in treating chronic non-cancer pain. The document also advises physicians when starting a patient on opioid therapy, the guidelines recommend dosages less than the equivalent 50 milligrams of morphine per day and no more than 90 mg per day.

The guidelines state that “patients already receiving high-dose opioid therapy should be encouraged to embark on a gradual dose taper, and multidisciplinary support should be offered where available to those who experience challenges.”

“Poor prescribing has been identified as a significant contributor of opioid addiction and overdose. The public and the profession is looking to the regulator to address unsafe prescribing practices”, said Dr. Grant. “The College would expect new prescriptions to be in alignment with the guidelines. However, for those patients already on high doses, care must be taken when attempting to taper these medications. Withdrawal can be dangerous and rapid decrease in daily doses or sudden discontinuation is never acceptable,” said Dr. Grant.

The College is committed to patient safety and recognizes the new Canadian guidelines as an important step in ensuring safe and appropriate use of opioids for chronic non-cancer pain management.

Ryan Demings
Communications Officer
College of Physicians and Surgeons of Nova Scotia
Phone: 902-482-2919