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 …

Prescribing changes for Buprenorphine/Naloxone (Suboxone®)

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

Buprenorphine is a partial opioid receptor agonist available in Canada since 2007. It is most commonly prescribed in combination with opioid antagonist naloxone as Suboxone® in sublingual tablet form. Buprenorphine is as effective as methadone for treatment of opioid dependence but with an improved safety profile. The agonist/antagonist action of Suboxone® creates a “ceiling effect” which makes it less likely …