In an effort to curb misuse of opioids and forestall overdose deaths, the Faculty of Physicians and Surgeons of British Columbia launched a legally enforceable apply normal, Protected Prescribing of Medication with Potential for Misuse/Diversion, in 2016. This doc restricted prescribing of opioids for continual noncancer ache (CNCP) with particular prescribing practices that clinicians had been obligated to observe.

In analysis that examined the consequences of the 2016 apply normal on prescribing to sufferers with CNCP, researchers discovered that its introduction had a marked affect on prescribing practices. Pre-existing declining tendencies in doses of opioids (measured in morphine milligram equivalents) accelerated, as did declines in high-dose prescribing, coprescribing with hypnotics like benzodiazepines, and prescribing bigger provides of medicines. As properly, the variety of sufferers who had doses aggressively tapered elevated, which can lead to improper ache administration. The evaluation included information on all opioid prescriptions disbursed to community-living adults in BC between October 2012 and March 2020.

“This demonstrates the flexibility of apply requirements to switch doctor conduct but in addition highlights how misinterpretation can hurt sufferers,” writes Dr. Dimitra Panagiotoglou, affiliate professor at McGill College, Montréal, Quebec, with coauthors. “Affected person teams and physicians affected by requirements or tips ought to be consulted earlier than their launch to scale back unintended penalties.”

When the 2016 apply normal was changed in 2018, the downward tendencies slowed.

“These findings show that prescribing tips and apply requirements can have rapid and long-lasting results on doctor prescribing. Though many of the modifications could also be optimistic (e.g., fewer opioids in the neighborhood, a discount in coprescribed benzodiazepine), incorrect interpretation can enhance harms for some sufferers. Aggressive tapering can have downstream penalties, together with folks resorting to unregulated opioids for ache aid regardless of their dangers,” write the authors.

Individuals residing with continual ache and opioid use dysfunction (OUD) in Canada are sometimes unable to entry evidence-based therapy, which might scale back effectiveness of remedies for OUD, in line with a commentary in the identical situation.

“Overcoming obstacles – akin to siloed look after OUD and continual ache, and restricted entry to allied well being providers that may enhance ache administration and OUD outcomes – is crucial to successfully addressing the wants of sufferers with comorbid OUD and continual ache,” writes Dr. Kiran Grant, an emergency medication resident on the College of British Columbia, Vancouver, BC, with coauthors.

They recommend interdisciplinary approaches, akin to together with ache administration specialists in care, might assist enhance outcomes for folks with continual ache and OUD.

“The consequences of a provincial opioid prescribing normal on opioid prescribing for ache in adults: an interrupted time-series evaluation” and “Integrating continual ache administration into look after sufferers with opioid use dysfunction” are revealed Could 12, 2025.