Physician says local opioid prescription rate still too high

The region that includes Sarnia-Lambton, Windsor-Essex and Chatham-Kent still has one of the highest rates in Ontario for opioid prescriptions for pain. “Despite the opiate crisis and the public awareness, we’re not seeing the opiate prescribing go down like we should,” said Dr. Blake Pearson, the new physician lead for opiate reduction for the Erie St. Clair Local Health Integration Network (LHIN). “So my whole goal is to educate on alternatives and establish programs so we can reduce the rates of opiate prescribing within our LHIN.”

The Ontario Drug Policy Research Network said the rate (per 1,000 people) of opioid prescribing to individuals for pain in 2017 ranged, in different regions across Ontario, from 85.7 to almost double that, at 168.4. The rate in the Erie St. Clair region was 157.2. That’s down about seven points from the rate in 2016, in line with the trend in Ontario, but still at the high end of the provincial spectrum. Pearson, a doctor specializing in medical cannabis as treatment for nursing home patients with conditions such as epilepsy and chronic pain, said he’s waiting until he officially starts in his physician-lead role later this month to delve into specifics about his strategy.

“I am looking forward to collaborating closely with doctors, health-care professionals and other experts across the ESC region to develop a progressive strategy to make a real impact on the opioid and other addiction problems afflicting our community,” he said in an email. Pearson recently returned from several conferences in Israel, the United States and Canada, where he presented his research on cannabinoid medicine. He said there was some “really compelling evidence,” from not just him but researchers in Israel as well, that cannabis use can reduce the use of antipsychotic drugs and opioids in elderly patients.

“I think we’re still a little bit away from physicians as a whole accepting this because of that lack of randomized, controlled doubleblind trials that we’re used to as the gold standard,” said Pearson, noting research is underway. Irfan Dhalla, a vice-president with Health Quality Ontario, said a lot of the harm in the opioid crisis stems from street drugs, but reducing prescriptions where reasonable can also help.

“We do prescribe opioids a lot more than physicians do in many other countries, so it’s probably a good thing if we are starting opioids a little bit less often.” In Canada in 2017 about 4,000 people died from reported opioid overdoses. Health Quality Ontario doesn’t have an official position on prescribing medical cannabis as an alternative, Dhalla said.

“But I know that many physicians feel that it is very reasonable to prescribe medical marijuana particularly if it is going to result in somebody who is on high doses of opioids coming off those medications.”

Pearson advises patients to consult a doctor before starting cannabinoid medicine because it can interact with other medications. “Just because it’s legal doesn’t mean it’s safe necessarily.”

Despite the opiate crisis and the public awareness, we’re not seeing the opiate prescribing go down ...