A Message to Albertans on Opioid Prescribing

Recent media coverage has led some Albertans to believe that the College of Physicians & Surgeons of Alberta (CPSA) discourages physicians from prescribing opioids, and that patients have been abandoned by pain specialists. We have also heard that some physicians have stopped prescribing opioids or have refused to treat patients with chronic pain, because they are afraid of losing their medical licence. These situations are putting lives at risk and must be addressed.

CPSA strives to ensure Albertans receive safe, quality health care from their physicians. Alberta is incredibly fortunate to have some of the best physicians working hard to stay informed on most recent care guidelines, which often change with new research.

This research shows that opioids, once believed to be safe, effective and risk-free, can be very dangerous when prescribed in high doses or used long-term. Opioid overuse and misuse has become a crisis in our communities and we must work together to find solutions.

To protect Albertans, physicians from across the province have come together to address a crisis that was in-part caused by overprescribing. Today, Alberta’s physicians are more aware of safe prescribing practices. Even still, we continue to hear some physicians are resistant to take on new pain patients due to the complexity of opioid prescribing.

There are a variety of reasons why a physician may need to transition patients to a new health care provider: retirement, change in scope, or an agreement with CPSA. Regardless of the reason, patients are expected to receive adequate notice and support in transitioning their care, and the profession as a whole needs to support these patients in need.

CPSA recognizes pain patients need quality care from doctors who understand their illnesses and who can offer safe amounts of medication to improve daily living while reducing pain. Our expectations of physicians have always been consistent:

• It is never appropriate to abandon a patient on long-term opioid therapy, or abruptly cut off or threaten to cut off a patient’s medication. If reducing long-term opioid medication is the appropriate course of action, it requires expertise and support to be done safely. Specialized clinics and resources for physicians are available at cpsa.ca.
• It is never appropriate to refuse care to a patient because they have complex medical needs or use opioids. All Albertans deserve access to the care they need and physicians must treat all patients equally.
• Patients taking prescribed opioids should never be stigmatized. There are some medical conditions where opioid use is appropriate. Any person taking an opioid can develop dependence over time, this is a known risk of the medication and not the patient’s fault.

CPSA understands that inappropriate prescribing was a contributor to today’s opioid crisis. That does not mean that all opioid prescribing is bad; there are many people on high doses that are doing very well as a result of their treatment. It took decades for this crisis to develop and it will take years for it to be resolved. We want to work with physicians and patients to find solutions for this complex problem.

CPSA recognizes that the vast majority of physicians prescribe opioids appropriately, but we can all improve. We provide physicians with reports and resources to help ensure they are aware of their prescribing trends/best practices and are prescribing appropriately. We encourage them to collaborate with their patients, evaluate the risks of any medication and make informed, safe medical decisions that are in the patient’s best interest. We understand that chronic pain is a very complex issue and there are patients who need opioids to be able to live their lives. I know there are many physicians providing excellent care to Albertans and I would like to personally thank them.

Providing compassionate care to those with chronic pain is not easy, but we expect all physicians to embrace the needs of those patients and support them in their care requirements. If you are a chronic pain patient who can’t find support, or a physician who wants support treating patients with chronic pain, please contact us at CC.Inquiries@cpsa.ab.ca, or 780-969-4935. As the CPSA’s Registrar, I do not want to see a single chronic pain patient abandoned by their physician.

Dr. Scott McLeod
CPSA Registrar