While the availability of illicit opioids (especially fentanyl) is a significant factor in the crisis, a recent study shows that prescription opioids continue to play a substantial role. There are approximately 53 opioid prescriptions filled each year for every 100 Canadians, making Canadians the second highest consumer of opioids in the world. While the years between 2012 and 2016 saw a decline in the quantity of opioids being dispensed in Canada, that same period saw a shift towards an increased number of opioid prescriptions and prescribing of stronger opioids, which is cause for significant concern.
This has presented a delicate challenge to health care providers as great care is needed to provide pain sufferers with treatment, while minimizing the risks associated with opioid prescribing. While there are no silver-bullet solutions, there are opportunities to better support healthcare providers and reduce the risk to patients.
An important place to start is modernizing how prescriptions are transmitted between prescribers and pharmacies. PrescribeITTM is a national electronic prescribing service that will transition the prescribing process from one that is heavily reliant on paper and faxed prescriptions to one that is fully electronic. In addition to providing better information at the point of care, inadvertent errors, forgery and fraud can all be reduced.
One key benefit of e-prescribing is that it makes it easier for prescribers to write prescriptions for a small quantity of opioids, knowing that they can remotely order an additional supply if the patient needs it. This is significant because studies have found that a high number of patients have unused opioids after surgery (between 67% and 92%) resulting in a surplus of opioids in medicine cabinets across the country. Sadly, leftover opioids are frequently stolen and misused. A study of students in Ontario from grades 7 to 12 found that 21% admitted to taking opioid prescription drugs for non-medical reasons, and of those students 72% reported obtaining them from their homes.
By implementing a modern, electronic national prescribing system, opioid prescriptions can be transmitted safely and securely. The service enhances team-based, patient-centred care by providing secure two-way communication between prescriber and pharmacist. A pharmacist concerned about dosages, or potential dangerous drug combinations can quickly message the prescribing clinician and in turn prevent a tragic outcome. The system also allows prescriptions that are no longer needed by the patient to be cancelled electronically.
As the opioid crisis continues to escalate, one improvement that can be embraced to better serve Canadians, is the move from the dark ages of faxed and paper prescriptions to a modern, secure, electronic prescribing service like PrescribeITTM.
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