Ontario is facing a serious public health and safety issue related to opioid use disorder, including prescription narcotics and other controlled substances.
Framework for Improving the Safety and Security of Controlled Substances in Hospital High Risk Areas
The College has recently published the Framework for Improving the Safety and Security of Controlled Substances in Hospital High Risk Areas. The framework contains 13 recommendations to enable healthcare system stakeholders to proactively identify and prevent the diversion of controlled substances in hospitals. The diversion of controlled substances can have a substantial impact on patients, staff and organizations. Identifying gaps in awareness, policies, procedures and capacity that increase avenues for diversion and acting to bridge these gaps is vital to preventing diversion in hospitals.
The framework was developed by The Partnered Table to Improve the Safety and Security of Controlled Substances in Hospital High Risk Areas, which was sponsored and initiated by the College and includes healthcare providers, hospital leadership, regulators and other subject matter experts among its membership.
Pharmacists and pharmacy technicians working in hospitals are encouraged to become familiar with the recommendations, identify any gaps that might exist in their practice setting, and bring the framework to the attention of pharmacy and hospital leadership. It will be important to look for opportunities for collaboration with other healthcare professionals to identify where there is a role for pharmacy professionals to adjust, enhance or share practices around Controlled Substances.
Opioid Dispensing in Ontario: 2018 Snapshot
In line with its ongoing commitment to encourage the use of data and evidence to support quality and safe pharmacy practice, the Ontario College of Pharmacists is pleased to announce the publication of the Opioid Dispensing in Ontario: 2018 Snapshot.
The snapshot is intended to provide an overall look at opioid dispensing patterns in community pharmacy in Ontario related to three areas of analysis that are considered high-risk dispensing practices.
Through the release of the snapshot, the College is seeking to better understand practice behaviours, with the primary goal of identifying areas for further teaching, coaching and collaborating with pharmacy professionals in preventing opioid-related harms. We also recognize that there is growing public, patient and health system stakeholder interest in understanding the role of pharmacy in helping to reduce the human and societal impact associated with the opioid crisis in our communities.
Of equal importance is the use of data and resources in providing pharmacy professionals with information to help them evaluate and enhance their own practice as medication experts. Pharmacy professionals are strongly encouraged to assess their own dispensing practices, including reviewing the data analysis available, to look for opportunities to enhance the patient care they are providing through patient education, collaboration with prescribers and other appropriate actions. To assist with this, the snapshot outlines a number of key considerations for pharmacy professionals who are dispensing opioids.
College’s Response to Opioid Crisis
The College is committed to supporting and complementing action undertaken by provincial and federal governments and other health system stakeholders to reduce opioid use disorder and prevent overdose and addiction. Already, we have focused on ensuring pharmacy professionals have access to educational resources to help them provide the best possible care for their patients. These include:
- creating an opioid practice tool as a hub for relevant resources,
- educating pharmacy professionals of their obligations related to opioid and narcotic security (e.g. Patch for Patch program),
- providing guidance on the dispensing of naloxone,
- making pharmacy professionals aware of external resources on best opioid prescribing and dispensing practices, and
- encouraging inter-professional collaboration between prescribers and dispensers.
To further this work and ensure we are doing all we can do to address this crisis, the College has announced the creation of an opioid strategy.
A Comprehensive Opioid Strategy
The strategy, which was developed by the Opioid Task Force, addresses relevant areas of practice, and considers the health and social factors that are related to opioid use disorder. The full strategy was approved by College Council at its September 2017 meeting.
The College recognizes that no single initiative will fix Ontario’s opioid-related issues and is committed to aligning with national and provincial opioid-related goals. To ensure that a sustainable and effective approach is taken to address opioid-related issues, the multi-pronged strategy simultaneously addresses relevant areas of practice.
This strategy supports the College in meeting its mandate to serve and protect the public’s interest by:
- advancing opioid-related education for pharmacy professionals,
- improving harm reduction strategies and delivery of opioid dependence treatment,
- preventing overdose and addiction by supporting evidence-based and appropriate dispensing practices, and
- strengthening oversight of the provision of narcotic and controlled drugs to patients and the security of drug distribution.
These priorities are supported by five strategic areas of focus: sourcing, developing and communicating practice tools and resources; optimizing scope of practice for pharmacy professionals; applying best practices and guidelines supported by evidence; using data to inform activities; and building collaborative relationships with relevant healthcare partners.
Read the FAQs on the Opioid Strategy.
With the approval of the strategy, College staff will prioritize and implement the key initiatives identified, with the support of an external working group where required. Additional opioid-related initiatives will continue to be undertaken by the College. At each Council meeting, progress on opioid-related initiatives will be reported through the Registrar’s Report.
Read a February 2018 Update on the College’s Opioid Strategy.
Pharmacy Stewardship for Patient Safety
Pharmacy professionals play an important role in the procurement and distribution of narcotic and controlled substances for use in patient care. Therefore, they have a professional responsibility to take action to decrease the burden of current opioid issues faced by society.
The Code of Ethics, Standard 2.1 notes that members shall “utilize their professional judgment to make every reasonable and conscientious effort to prevent harm to patients and society. As medication experts, pharmacists are in a unique position to support the appropriate use and access to narcotic and controlled substances and collaborate with other health care professionals to enhance patient safety.