(Montreal) A new report advocates the use of pre-written prescriptions to standardize opioid prescribing practices, based on age and type of surgery, as a strategy to combat the crisis surrounding the misuse of these drugs.
Specifically, it is recommended to pay particular attention to the number of doses allowed on the prescription; to ensure that a validity period appears on the prescription; and to add a mention to report unused doses of opioids for destruction.
“Pain after surgery normally doesn’t last for months,” recalled the report’s co-author, Élaine Pelletier, who is a pharmacist at CHU Sainte-Justine.
It therefore happens regularly that unused tablets end up in circulation in nature, which opens the door to possible abuses.
Adding a sort of “expiration date” to prescriptions, a date after which they can no longer be used to obtain medication, could go some way to curbing the problem of misuse by preventing prescription holders from using them at random times and in any way they like.
We know that adolescents in particular are at higher risk of re-using opioids that were prescribed to them, that they did not use and that they kept. Or they will use their prescription a little later when they no longer need it, or they will find them in the homes of parents or friends who store them at home.
Élaine Pelletier, pharmacist at CHU Sainte-Justine
This consumption, which begins in adolescence, could have harmful consequences in the short, medium and even long term for the young person, she recalled.
The report’s authors chose to focus on postoperative pain relief because that’s when patients will often be exposed to opioids for the first time, M explained.me Furrier.
“In general, our prescriptions are well done,” she said. “But we think that we should perhaps insist on the duration of the validity of the prescription, both at the level of prescribers and at the level of families and patients.”
This report from the Therapeutic Drug Management Program (PGTM) provides for the first time a comprehensive picture of the situation in Quebec university hospitals, in addition to identifying several good practices to prevent inappropriate use of these substances.
The report “Descriptive analysis of opioid prescriptions given upon discharge following pediatric surgery in Quebec university hospitals” is a retrospective study of some 500 opioid prescriptions for the management of postoperative pain at home, i.e. all those given to people under 18 years of age between 1er April and October 31, 2021 in the four university hospitals in Quebec that perform pediatric surgeries.
The report recommends, for example, that young people and their parents be well informed about the expected benefits and risks associated with opioids, so that they are able to make informed decisions about the proper administration of these medications and their storage, it was specified in a press release.
Educational programs for both health care professionals and the general public are also suggested. For example, consideration is given to developing an electronic educational document to guide patients and their families on pain management, safe use of opioids, and proper disposal of unused quantities.
“Maybe we could also consider a quick questionnaire or a text message that asks the patient if they’ve taken any opioids in the last two weeks and reminds them to report any unused amounts,” Mr.me Furrier.
Ultimately, she concludes, opioids remain a very effective tool for relieving pain “and we must not only look at the risk.”
“It is an effective medicine when used properly, which has a utility,” she said. “But it is when the use is not correct and becomes non-medical that the risks can appear.”
The PGTM is an initiative that brings together the five university hospital centers of Quebec and which focuses on the optimal use of medications.