Canadian Opioid Guideline
Physician FAQs
Background
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- No. The new guideline is not a policy or standard of practice and provides advise to physicians.
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- The complete guideline and its condensed version is available in electronic format from the Michael G. DeGroote National Pain Centre website at McMaster University.
- Note: printed versions of the guideline will not be distributed due to budget constraints.
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- Yes, the guideline and related documents is being translated by the College of Physicians & Surgeons of Quebec /Collège des Médicins du Quebec and will also be available from the Michael G. DeGroote National Pain Centre website at McMaster University.
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- The complete guideline is more than 150 pages and includes tools and at-a-glance resources.
- A condensed version and online tools are also available to physicians.
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- There is no guarantee. However the complete guideline includes tools and at-a-glance resources to help physicians with decision-making. A condensed version is also available for quick reference.
- In the long run, time spent becoming familiar with the guideline will help physicians provide safer and more effective treatment for their patients.
Treating Patients with Chronic Non-Cancer Pain
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- The new guideline will allow physicians to determine and adjust patient treatment as needed, based on current, evidence-based information.
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- The guideline makes recommendations on what is safe and effective opioid treatment for chronic non-cancer pain (CNCP). Whether this is less or more than what a physician currently prescribes will depend on the individual patient and situation.
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- No. However, the physician should consider the most safe and effective treatment for his/her patient.
- Note: The guideline recognizes that some patients may require higher doses of opioids, such as when a patient benefiting from opioid treatement (for CNCP) develops a tolerance to his/her current dose.
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- The same measures currently employed by regulatory bodies will be in effect to monitor and identify if this occurs.
- If a physician’s regulatory body doesn’t track ‘doctor shopping’ or ‘double doctoring’, it will be important for the physician to use available information regarding the patient’s prescription history and opioid use.
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- Yes, but only if the physician determines there is a risk to the patient’s safety or the physician does not feel qualified to handle treating CNCP with opioids.
- In either case, alternate methods for treating chronic non-cancer pain should be considered.
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- Most physicians are interested in providing quality care to their patients, however some may choose to defer treatment to others more familiar with treating CNCP.
Chronic Non-Cancer Pain (Physician Reference)
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- Chronic non-cancer pain is classified as non-malignant pain that exists for more than six months. It is:
- commonly caused by low-back pain
- prevalent in Canadian seniors, osteoarthritis sufferers and those with neuropathic pain.
- a symptom of many diseases (e.g. diabetic neuropathy, post-herpetic neuralgia, arthritis, spinal disc herniation, stroke, and trauma) and may occur in the absence of a specific underlying diagnosis.
- the most common cause of long-term disability
- associated with increased use of health services.
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- The number of patients is significant and increasing; approximately 29 per cent of Canadians suffer from CNCP including:
- 38 per cent of institutionalized seniors, and 27 per cent of seniors living in households, who experience CNCP of some kind on a regular basis. Percentages in both scenarios are higher for women than men.
- Three million (10 per cent) Canadians who suffer from osteoarthritis – evenly spread between men and women.
- One million (three per cent) Canadians who live with neuropathic pain, including headaches and nerve pain.