Alberta doctors take aim at role in opioid crisis
Physicians in Alberta need to change the way they treat pain to reduce the number of opioid overdoses, say some of their Calgary colleagues.
While doctors in the province are headed in the right direction by decreasing the amount of opioids they prescribe, many of them need to chart new treatment directions, say physicians involved in the field, like Dr. Rita Henderson.
One of those is to refer patients struggling with opioid dependency to treatment using suboxone and methadone that will gradually wean them from addiction, she said.
“We need family physicians to be on board with these initiatives,” said Henderson.
“If they are stalling, the time it takes to go into withdrawal is prolonged.”
A de-prescribing policy in Alberta dating back about three years has led to physicians approving 30 per cent fewer opiates, though those are largely centred on codeine and Tylenol 3s, said Henderson.
She acknowledged a perception of doctors working in league with pharmaceutical companies eager to push potentially harmful medications remain, but it’s one that’s now vastly overblown.
“The vast majority of family physicians are well-intentioned and are not driven by a profit motive but they may not be aware of these alternatives,” said Henderson.
Dr. Lori Montgomery agrees, saying that was a more tangible reality years ago.
“It’s relatively rare, the number of physicians who do have a conflict of interest these days is smaller than 10 years ago,” said Montgomery of Alberta Health Services’ (AHS) pain program.
“Ten years ago, we didn’t know about the harms we do — back then, pharmaceutical companies were almost entirely responsible for the education.”
Beginning last summer, that education took a new turn with a training program to help physicians better understand the impacts of prescribing pain killers and how to safely taper off patients’ use of them.
In some cases, said Montgomery, bodies adjusting to pain killers over time can lead to opiates actually becoming a source of pain, a phenomenon noted in the education material.
“There’s a balance of risks and benefits and the more we study it, the more we find other things are more effective,” she said.
The online modules and in-person workshops are a partnership between the AHS, University of Calgary and the College of Physicians and Surgeons of Alberta.
“We’ve had lots of interest in people taking up the online modules,” said Montgomery.
Reducing opiate intake and their duration of use is one way to prevent runaway addictions with often tragic consequences, she said.
“If there’s a place we can have an impact, we’re obligated to try,” said Montgomery.
A school of thought, one that’s been adopted by the federal NDP during the current election campaign, is that many now-illicit drugs, including street opioids, should be decriminalized.
That would put more of a focus on medical treatment while easing the way for governments to supply uncontaminated drugs such as fentanyl, argue proponents.