Opioid Strategy for Pharmacy

Ontario is facing a serious public health and safety issue related to opioid substance use disorder. As the regulator of pharmacy in Ontario, putting patients first has been and will always be our number one goal. We recognize that no single initiative will “fix” Ontario’s opioid-related issues. The College is committed to aligning with national and provincial opioid-related goals.

We know that, as healthcare professionals, pharmacists and pharmacy technicians have an important role to play in responding to serious public health issues affecting our patients, communities and the province at large. The College believes that the profession of pharmacy can help with improving opioid-related care for patients, encouraging harm reduction, preventing overdose and addiction, and ensuring quality oversight of the provision of narcotics and controlled drugs to patients and proper destruction of any unused medications.

There are many complex health, social and system factors that have contributed to this current crisis. However, this is a public health crisis that requires action on all fronts.

As medication experts, pharmacists are in a unique role to support the appropriate use and access to narcotic and other controlled drugs. They are also in a position to engage in collaboration with other health care professionals to enhance patient safety. Additionally, pharmacy professionals are often the most accessible healthcare providers for patients and so may have opportunities to develop and identify best practices and provide additional support and education around opioid issues.

Hospitals are encouraged to review the framework’s recommendations to look for opportunities to enhance their own management of Controlled Substances in high risk areas. There should be collaboration across the hospital to identify any gaps and implement any necessary changes to policies, procedures, reporting, or training.

Hospitals are encouraged to establish key performance indicators (KPIs) to evaluate their progress on improving the safety and security of Controlled Substances. Such indicators may include, but not be limited to, the number of Health Canada loss and theft reports, the number of confirmed diversions and the results of physical security and process audits on a regular basis to track the impact of their diversion prevention and mitigation strategies.

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

The members of the Partnered Table to Improve the Safety and Security of Controlled Substances in Hospital High Risk Areas, including the College, will work collaboratively to identify future opportunities to measure the impact of the recommendations from the framework on diversion within hospitals and to hear feedback on implementation.

College hospital operations advisors will be sharing and discussing the framework with hospital teams as part of their regular operational assessments in addition to activities and dialogue already underway during these visits regarding ensuring the security of Controlled Substances.

The sponsorship of the framework by the College is part of our Opioid Strategy. Therefore, the College will also focus on encouraging implementation of the recommendations within hospitals by working collaboratively with various health system stakeholders.

Various health system stakeholders were involved in the information gathering, drafting and review of the framework.

To ensure a wide regulatory lens was reflected in the framework, both the College of Physicians and Surgeons of Ontario and the College of Nurses of Ontario were given an opportunity to review the framework and provide feedback. They have also agreed to post the framework on their websites for use by their registrants.