Doctors must accept responsibility for Canada's opioid crisis, but they need help from governments to develop effective solutions, the leaders of several physician regulatory bodies say.
The comments come after a Globe and Mail report in which federal Health Minister Rona Ambrose accused the country's doctors of fuelling the epidemic of prescription drug abuse with inappropriate overprescribing of the potent drugs. Canadian doctors write enough opioid prescriptions to give a dose to every Canadian between the ages of 20 and 60, the report revealed, with the number of high-dosage prescriptions climbing quickly.
Ms. Ambrose's comments about doctors are "obviously true," said Ed Schollenberg, registrar of the College of Physicians and Surgeons of New Brunswick. "I don't think we've got a really good action plan [for Canada.]"
Andrew Padmos, CEO of the Royal College of Physicians and Surgeons of Canada, agreed that the country's doctors must do more to reduce opioid prescribing – while still providing help to those patients facing chronic pain. "It's easy to go too far and it's easy to go too short," he said of the balancing act.
The Royal College has developed projects to help educate physicians about safe prescribing and the potential risks of opioids, Dr. Padmos said, but added that a problem as complex as this will require a comprehensive strategy.
Opioids are powerful, addictive painkillers, such as oxycodone, fentanyl and hydromorphone. Canadians consume more opioid drugs per capita than any other country except the United States. Ontario has the highest rates of doctors prescribing high-dose opioids.
Rocco Gerace, registrar of the College of Physicians and Surgeons of Ontario, the province's medical regulatory body, shares Ms. Ambrose's view that doctors deserve some blame for the problem. But, he said, the lack of an urgent response from governments is stopping effective solutions from being put in place.
"I really wish we would get out of the business of blaming each other for a serious problem that we all own," he said.
"We as a profession have to do something about [inappropriate prescribing]," he said, adding the problem "is very complicated – let's sit together and work together and together we'll find solutions."
All players, including the federal and provincial governments, as well as other regulatory bodies, need to come together to tackle the crisis, he said.
Dr. Gerace said after publishing a report on the crisis in 2010, the college attempted to bring stakeholders together to deal with the opioid crisis, but "it didn't happen." He declined to indentify which individuals would not come to the table.
Dr. Schollenberg said New Brunswick has no monitoring program, which makes it hard to understand where potential abuse may be occurring. He said he would like to contribute more to finding a solution, but is unsure what actions will be effective and how to coordinate them.
The federal government has announced plans to update warning labels on opioid drugs to reflect the fact they can be addictive and should be used to treat severe pain. The government is also considering making all opioids harder to crush and abuse. That would affect recreational drug users, but not the many Canadians who use opioids on the advice of their doctors.