Exploring Opioid Use and Safe Supply in Ontario
Ontario continues to see the devastating effects of the opioid crisis, which has been heightened by the impact of the COVID-19 pandemic. Ontario experienced a significant rise in opioid-related deaths in 2020 versus 2019 as community support services and safe consumption sites closed and harm reduction approaches that included not using drugs alone had to be abandoned during stay-at-home orders.
With the aim of harm reduction and minimizing opioid-related overdoses and deaths, there has been a growing interest in exploring emerging or alternative means of treating and supporting those who use opioids. One of these evolving clinical practices is providing a safe drug supply using pharmaceutical medications to respond to the needs of some patients and to offer an alternative to the increasingly toxic street supply of illicit opioids.
Safe drug supply refers to prescribing pharmaceutical-grade opioids to patients with opioid-use disorder as an alternative to the increasingly toxic street supply of illicit opioids.
An Opioid Strategy for Pharmacy
The College continues to monitor the impact of public health measures on the ability of Ontarians to access the medications they need, and is committed to supporting and complementing action by provincial and federal governments and other health system stakeholders to reduce opioid-related harms.
The College’s opioid strategy for pharmacy aligns with national and provincial opioid-related goals of preventing overdose and addiction, and considers the social factors that are related to problematic opioid use.
Key Considerations for Safe Supply Opioid Dispensing
If considering safe supply opioid prescribing, registrants are reminded of their professional expectations to:
Practise within the limits of your clinical competence and/or scope of practice.
Review previous interventions the patient has undergone.
Demonstrate sound clinical judgment, taking into account the individual needs of each patient.
Consider and apply relevant practice standards, quality standards, and clinical practice guidelines, where they exist.
Where relevant practice standards, quality standards, and clinical practice guidelines do not exist, or in areas of medicine that are less developed, consider the best available indirect evidence, including clinical trials and evidence-based research to help inform consensus protocols or best practices.
As always, pharmacy professionals are expected to use their knowledge, skills and judgement and take into account the individual needs of each patient when dispensing medication. Pharmacy professionals must also assess the authenticity of the prescription and the appropriateness of the prescription for the patient.
Optimal patient care cannot be achieved in a vacuum – pharmacists are expected to collaborate with other healthcare professionals when providing care and to communicate effectively. Collaborating with the prescribing practitioner is an effective way of supporting safe, quality patient care and is particularly important for prescriptions for controlled substances as outlined in the Controlled Drugs and Substances Act, 1996.
Only by practicing within the limits of clinical competence, demonstrating sound clinical judgment, and collaborating with other healthcare professionals/peers can pharmacy professionals best support their patients through safe supply opioid dispensing.
