Chair's Message – Opioid deaths and prescribing

As many of you know, opioid use and abuse hits the news regularly these days, and for good reason.

Fentanyl – related deaths have dramatically increased in Ontario according to a recent analysis of data from the Ontario Chief Coroner’s Office.

Compared to 2016, levels of accidental opioid – related deaths have risen by 52 per cent in Ontario for 2017, 43 per cent in British Columbia, and 40 per cent in the Alberta. This is, on average, three-four opioid – related deaths per day in Ontario. Over 80 per cent of these deaths are judged accidental after coroner’s investigations.

Alberta and British Columbia still have higher rates of opioid – related deaths than Ontario, but we are catching up fast. The percentage of opioid – related deaths involving Fentanyl has jumped to 68 per cent in Ontario, and approximately 80 per cent in British Columbia and Alberta. Fentanyl and its analogues are the big killers in this epidemic of deaths.

Other opioids contributing to cause of death in accidental deaths in Ontario in 2017 include: Heroin (11 per cent), Methadone (14 per cent), Hydromorphone (10 per cent), Oxycodone (9 per cent), Morphine (14 per cent), and Codeine (4 per cent).

It seems that prescription of drugs for chronic non-cancer pain by physicians with the possible exception of Fentanyl, makes a small contribution to accidental deaths from drug use. However, it doesn’t mean that this can be ignored, and family physicians should use the tools and resources at their disposal to assess and modify, if necessary, their approach to opioid prescribing.

Several examples of resources for this can be accessed from the Southwest Primary Care Alliance website. From there you can link to My Practice/Primary Care where you can receive a confidential report on your own opioid prescribing compared to provincial averages. In addition, you can link to Guidelines, other Tools, and the Opioid Wisely recommendations, a spin off from the Choosing Wisely campaign.