New opioid prescribing guidelines aim to cut use of potent narcotics
TORONTO — Updated opioid-prescribing guidelines released Monday encourage doctors to avoid giving the powerful narcotics as a first-line treatment to patients with chronic, non-cancer pain and instead try other medications or non-pharmaceutical therapies to prevent a host of potential harms associated with the widely used drugs.
Those harms include physical dependence or addiction, as well as the increasingly common risk of fatal overdoses. An estimated 2,000 Canadians died of opioid overdoses in 2015 alone, and initial 2016 data still being tallied suggest the number of fatalities linked to the drugs — both prescription and illicit — could far exceed that figure.
“It really comes down to the paradox of trying to provide important relief for patients dealing with unrelenting chronic pain while at the same time balancing the risks associated with the medications,” said Dr. Jason Busse, a researcher at the National Pain Centre at McMaster University and lead author of the 10-recommendation document.
For patients whose chronic pain is not controlled with non-opioid therapy, the panel of experts that developed the guidelines says dosages of opioids like oxycodone, hydromorphone and the fentanyl patch should be restricted to less than the equivalent of 90 milligrams of morphine per day, and ideally to less than 50 mg.