A message to albertans

We care about patients living with chronic pain




As physicians, we want to relieve pain. That’s why opioid medications became so widely prescribed so quickly – the medical profession was taught that opioids are effective and safe. Today, we know that opioids can be used effectively to relieve pain for short periods of time such as after surgery, and are an important therapy for managing cancer-related pain.

But for patients with chronic pain, opioids are less effective and less safe than we thought. Recent evidence shows a strong correlation between prescription opioid use and overdose deaths, particularly when high doses are prescribed. Patients taking opioids for longer periods of time are much more likely to develop dependence on the medication itself and as a result find it very difficult to reduce or discontinue use. Prescription opioids are also being diverted in large quantities for illegal sale on the street.

Opioid overuse and misuse has become a crisis in our communities, and we must find solutions.

As the regulator of Alberta’s medical doctors, the College of Physicians & Surgeons of Alberta recognizes overprescribing has contributed to the opioid problem, and we are putting safeguards in place to protect patients and the public.

The CPSA is NOT asking physicians to stop prescribing opioids, but to prescribe responsibly.

The College expects physicians to prescribe safely for patients already on long-term opioid therapy, to take steps to prevent diversion and to be very cautious in initiating opioids for new patients with chronic pain. The CPSA wants patients and physicians to understand:

  • It is never appropriate to abandon a patient on long-term opioid therapy, or abruptly cut off or threaten to cut off the patient’s medication. Safely reducing long-term opioid medication requires expertise and support. Links to specialized clinics and resources for physicians are available on the CPSA website (cpsa.ca/physician-prescribing-practices).
  • The lowest effective dose is the safest dose. For the safest care, and to reduce the potential for unused medication to be diverted to non-medical use, we are directing physicians to prescribe the lowest effective dose and regularly re-assess the patient.
  • Patients taking prescribed opioids should not be stigmatized. Any person taking an opioid medication can develop dependence over time. This is a known risk of the medication, and is not the fault of the patient.

The CPSA is providing physicians with customized data and developing a new standard of practice to help them improve their prescribing practice.

We are also working with Alberta Health, healthcare providers and other community partners to find solutions to this complex health issue.

Sincerely,

Dr. Trevor Theman, Registrar
College of Physicians & Surgeons of Alberta

Click here for a PDF version.

Published December 2016