Stop doc shopping
When Jordan Miller died of an opioid overdose in Victoria in 2014, his mother, Leslie McBain, says the young man was receiving prescriptions from as many as five physicians.
Sadly, that would hardly have been unusual. In Alberta, for instance, figures show that nearly 40 per cent of those who fatally overdosed on opioids had been prescribed the drugs by at least three different doctors in the year before they died.
This practice of addicts “doctor shopping,” which has done so much to enable the epidemic of opioid overdoses, is about to get much more difficult in British Columbia and Alberta, two of the hardest-hit provinces.
Governments there are adopting welcome guidelines that will require physicians to check patient histories in databases before they initiate or renew a prescription for the powerful drugs. The systems will immediately alert doctors if their patients are already receiving prescriptions for the drugs from other physicians.
It’s a good plan in the face of an overdose emergency that has done particular damage on the West Coast. And as the crisis spreads east, Ontario should look to the new guidelines as a model.
The terrible toll of opioid addiction is already being felt here. Last year, the Office of the Chief Coroner said opioid overdoses were killing an average of two people in Ontario every day, making it the province’s third-leading cause of death. In 2015, the last year for which statistics are available, 710 overdose deaths were attributed to opioids. The roots of the problem go beyond doctor shopping. Health experts across the country say the ballooning opioid crisis can’t be solved until physicians stop prescribing the drugs so freely.
From 2006 to 2012, opioid prescriptions in Canada rose by 32 per cent, putting us among the top-prescribing countries per capita in the world. As Alberta’s interim Liberal leader, David Swann, who is also a physician, pointed out at this week, “75 per cent of addicts were started by doctors.”
To redress this alarming state of affairs, B.C.’s College of Physicians and Surgeons became the first medical regulatory body in Canada to release new mandatory standards for prescribing opioids last June. They are much more restrictive than the Canadian guidelines, which are due to be updated soon.
Ontario Health Minister Eric Hoskins, meanwhile, took a good first step to stopping the over-prescribing of opioids last November when he passed on the names of 86 doctors to Ontario’s College of Physicians and Surgeons for investigation after they were flagged by a new computerized narcotics monitoring system for their “unusual” prescribing patterns.
But much more can be done to contain the opioid crisis before it worsens in Ontario. Hoskins should start by following the lead of B.C. and Alberta and crack down on doctor shopping in this province.