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Pain Management and Opioid Prescribing

In 2016, the ​College of Physicians and Surgeons of British Columbia (CPSBC) ​created new opioid prescribing standards (Safe Prescribing of Drugs with Potential for Misuse or Diversion) in response to BC's growing opioid crisis, meaning that BC doctors are now legally bound by mandatory professional standards for safe prescribing of opioids and other addictive drugs.

In addition​, an updated ​clinical practice guideline for treatment of opioid use disorder from the BC Centre for Substance Use comes into effect​ on June 5, 2017, replacing the original CPSBC guidelines.

Until June 5, 2017:
College of Physicians and Surgeons of British Columbia: Clinical Practice Guideline for Opioid Use Disorder
As of June 5, 2017: ​BC Centre for Substance Use: A Guideline for the Clinical Management of Opioid Use Disorder

To assist physicians in complying with these guidelines and standards, and ​to help address ​substance use issues in their own communities, many divisions of family practice are hosting local learning events and ​creating and compiling resources on opioid prescribing and alternative pain management modalities​.

Some of these are clinical resources intended for a physician audience (i.e., to support decision-making in the prescribing process) and some are resources and community links that physicians can provide to patients on ​alternative pain management strategies.

To learn more about what divisions are doing to support physicians with opioid prescribing and pain management recommendations, see the links below.

Patient resources

Chilliwack

Mini Med School talk on Chronic Pain (view presentation).

Comox

Safe Opioid Practices page.
Public awareness talk (on Shaw TV) on local mental health and substance use issues and resources by Dr Charuka Maheswaran.


Physician resources

Central Okanagan

RACE (Rapid Access to Consultative Expertise) project (includes chronic pain specialists).
Link for members to Okanagan Interventional Pain Clinic.

Comox Valley

Comox Valley Safe Opioid Prescribing Algorithm.
Comox Valley Safe Opioid Prescribing Algorithm Resources and Tools.


Kootenay Boundary

Chronic Pain Management toolkit.
Chronic pain brochure.
Chronic pain resource list​ for Nelson and Lower Columbia (Trail, Rossland, Fruitvale) focusing on:
  • Medical Resources.
  • Cognitive Therapy.
  • Bodywork.
  • Self Management.
  • Complementary Methods.
  • Education.

Nanaimo

Opioid and ​pain ​resources for physicians (guidelines, assessment tools & information, and community resources).
Clinical resources for opiate and pain management.
Suboxone info sheet/handout (this resource can be repurposed by other divisions, crediting the Nanaimo division).
​Using a dedicated virtual mobile number (VMN) to set up a text hotline: A resource for divisions who may wish to set up their own e-mentor text support program for physicians.

Victoria

MHSU Learning Series - Navigating Opioids, Addiction & Pain: The Patient, the Physician, & the College.

Provincial (non-division) resources

Medical Services Commission (MSC) Payment Schedule. Includes April 26, 2017 update to fee items related to treatment of opioid use disorder.
Doctors of BC policy paper: "Improving chronic pain management."
Practice Support Program Pain Management Module.
College of Physicians and Surgeons of British Columbia: Safe Prescribing of Drugs with Potential for Misuse/Diversion.
BC Centre for Disease Control (BCCDC): Toward the Heart and Harm Reduction​​.

BC Centre on Substance Use: Clinical Care Guidance Publications and information sheets.
Pain BC: ​Conferences, assessment tools, and articles for health care providers.
Provincial Guidelines for Biopsychosocialspiritual Withdrawal Management Services: Guidelines for Adult and Youth.
UBC's "This Changed My Practice:" Managing Opioid Withdrawal.
Printable Ministry of Health rack cards, wallet cards, and posters on how to prevent overdoses. (To receive printed copies of these materials free of charge, fill out this order form and send to margaret.case@gov.bc.ca).

Health Authority resources

First Nations Health Authority: Substance Use Prevention and Treatment.
Fraser Health Authority: Mental Health and Substance Use.
Interior Health Authority: Mental Health and Substance Use Services.
Island Health Authority: Mental Health and Substance Use Services and Resources.
Provincial Health Services Authority (PHSA): BC Mental Health & Substance Use Services.
Northern Health Authority: Mental Health and Addictions.
Vancouver Coastal Health Authority: Substance Use Services.

GPSC fee codes and other supports

Doctors can access opioid agonist therapy support through GPSC fee incentives and Pharmacare coverage to address pain management and opioid prescribing. These include:

GPSC fee code G14043
– GP Mental Health Planning Fee: Payable upon development and documentation of a patient’s Mental Health Plan for patients residing in the community.

Updated MSP Fee Items for OAT: 00039, 15039, and 15040
Pharmacare coverage: Effective February 1, 2017, Pharmacare will cover Methado​se for maintenance and buprenorphine/naloxone under its Psychiatric Medications Plan (Plan G). More information:


 

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