Strategy to Prevent Opioid Addiction and Overdose
Modernizing opioid prescribing and monitoring
- Ontario's First-Ever Provincial Overdose Coordinator: Designate Dr. David Williams, Ontario's Chief Medical Officer of Health as Ontario's first-ever Provincial Overdose Coordinator. Dr. Williams will work with a number of key agencies and professionals, including Ontario's Chief Coroner's office, police services, health care professionals and public health officials to increase access to information concerning fatal and non-fatal opioid-related overdoses.
- Quality Standards: Develop evidence-based quality standards for health care providers on appropriate opioid prescribing, led by Health Quality Ontario and health sector partners.
- Appropriate Prescribing: Develop new, evidence-based training modules and academic programs in conjunction with educational institutions that will provide modernized training to all health care providers who prescribe or dispense opioids.
- Patient Education: Improve access to important medication information, including a patient guide, for all patients prescribed opioids to help them better understand the associated risks.
- Practice Reports: Provide reports through Health Quality Ontario to physicians that show how their opioid prescribing compares to that of their peers and to best practices.
- Narcotics Monitoring System (NMS): Make NMS data readily available to health care providers, including physicians and pharmacists so they have access to up-to-date dispensed medication information for their patients when making decisions concerning opioid prescribing.
- Overdose Monitoring: Launch a new overdose surveillance and reporting system to support Ontario's Chief Medical Officer of Health Dr. David Williams, in his role as Provincial Overdose Coordinator. Ontario is working with hospitals across Ontario to ensure that surveillance and reporting of opioid-related overdoses is up-to-date and robust.
- High-Strength Opioids: Beginning January 1, 2017, high- strength formulations of long-acting opioids will be delisted from the Ontario Drug Benefit Formulary. The government is currently working with health care providers, including palliative care clinicians, to ensure that Ontario patients can continue to access appropriate pain treatment.
- Province-wide expansion of the Fentanyl Patch for Patch Program: Beginning October 1, 2016, stricter controls on the prescribing and dispensing of fentanyl patches took effect. Patients are now required to return used fentanyl patches to their pharmacy before more patches can be dispensed.
Improving the Treatment of Pain
- Investing in theChronic Pain Network: Invest $17 million annually in multi-disciplinary care teams, including 17 Chronic Pain Clinics across Ontario, to ensure that patients receive timely and appropriate care to help them manage chronic pain.
- Expansion of the Low Back Pain Strategy: Expand access and availability of health care services for more Ontarians who suffer from low back pain. This comprehensive model of care includes a rapid low back pain assessment within an average of two weeks, as well as evidence-based management plans and educational tools to help patients manage pain.
- Chronic Pain Training for Health Care Providers: Expand training and support to primary care providers, including in rural and remote communities, to enable them to safely and effectively treat chronic pain. This will be done utilizing case-based learning and video-conferencing sessions with pain, addiction and mental health experts.
Enhancing addiction supports and harm reduction
- Expanded Access to Naloxone: Expand participation in the Ontario Naloxone Program. Naloxone, an antidote for opioid overdose is now available free of charge for patients and families through pharmacies and eligible organizations.
- Naloxone Kits for At-Risk Inmates: Work with the Ministry of Community Safety and Correctional Services to begin providing naloxone kits free of charge to at-risk inmates at the time of their release from provincial correctional institutions.
- Intranasal Naloxone: Explore providing naloxone in nasal spray form to first responders.
- Expand Access to Suboxone: Ensure that Suboxone, an effective treatment used to relieve opioid withdrawal symptoms that has a lower risk of overdose than methadone and reduces drug cravings is more widely available. Suboxone has a lower risk of overdose than methadone. Effective October 11, 2016, Suboxone is available as a General Benefit on the Ontario Drug Benefit Formulary. Ontario will ensure that access to Suboxone treatment is better integrated into a holistic, primary care approach to opioid addiction treatment.
- Nurse Practitioner Scope of Practice: Continue working with the College of Nurses of Ontario to enable Nurse Practitioner prescribing of Suboxone, improving access to a methadone alternative for patients struggling with opioid addiction, particularly for those in rural and remote areas.
- Indigenous Mental Health and Addictions Initiatives: Continue to work with Indigenous partners to identify community mental health and addictions priorities and ensure that culturally appropriate investments are made both on- and off-reserve to improve mental health and addictions issues in Indigenous communities.
- Harm Reduction: Work with experts and municipal leaders to develop an evidence-based harm reduction framework, which could include expanding needle exchange programs and supervised injection services which have been demonstrated to save lives and reduce costs within the health care system.
- Health Care Delivery and Primary Care Integration: Enhance integration of comprehensive primary care, mental health and Suboxone/methadone treatment to better support patients with opioid addiction.
Ontario will continue to work on additional longer-term initiatives for modernizing chronic pain services, transforming addictions treatment, and preventing injury and death associated with overdose.