Goldilocks approach to Narcotics Prescribing

College of Physicians and Surgeons of Alberta Messenger, Prescribing Corner, Professional Conduct Parapet, TPP Leave a Comment

Excellence is an art won by training and habituation. We do not act rightly because we have virtue or excellence, but we rather have those because we have acted rightly. We are what we repeatedly do. Excellence, then, is not an act but a habit. – Aristotle This issue of The Messenger includes the report of a physician disciplined for a lack of …

High Quantity Letters

College of Physicians and Surgeons of Alberta Messenger, Prescribing Corner Leave a Comment

The Triplicate Prescription Program identifies patients dispensed high quantities of triplicate medications at one time. In the second quarter of 2014, there were 87 pharmacy dispenses of over 1000 tablets in Alberta. Prescription drug misuse and abuse is a significant problem in Alberta and lost or stolen medications can put patients, their families and communities at risk. For patients who …

Important Facts about Methadone Maintenance Treatment (MMT) for Dependence that All Physicians Should Know

College of Physicians and Surgeons of Alberta Messenger, Prescribing Corner Leave a Comment

MMT is a substitution therapy for opioid dependence that suppresses withdrawal symptoms and cravings to allow for return to societal functioning. Patients on MMT show reductions in morbidity, mortality and use of illicit drugs and other opioids. Some patients are on methadone for life, while others may be successfully tapered off and remain abstinent. MMT is one component of a …

Calculation of Oral Morphine Equivalent doses

College of Physicians and Surgeons of Alberta Messenger, Prescribing Corner Leave a Comment

Calculation of daily oral morphine equivalent (OME) dose is an important practice tool when monitoring chronic pain patients or rotating opioid medications in a chronic pain or palliative patient. Hydromorphine is five times more potent than morphine and a 25 mcg/day fentanyl patch is equivalent to approximately 100 mg oral morphine daily. Monitoring total OME dose is an important tool …