Canada is the second highest per capita consumer of prescription opioids even though we don’t have good evidence for their efficacy for chronic pain. As various new guidelines describe, complications from prescription opioid use, including overdose and death, are related to dose. This is not widely appreciated by prescribers and patients alike. Since there are many different opioids used for the same purpose, we can use morphine equivalence to compare relative potency and thus also capture risks of dose related complications. Communicating risks of opioids is essential for informed consent and applying morphine equivalence is a core competency for opioid prescribing. UofT CPD, ISMP Canada and PROP collaborated to develop an infographic that could be used as a clinical, education and advocacy tool which could quickly communicate and reinforce these concepts of morphine equivalence and dose related risk. As the prescribing of opioids comes under greater scrutiny and there are increasing pressures to reduce prescribing and taper doses, we need tools that can facilitate evidence-informed discussions with patients. Tools that can get patients and prescribers understanding and speaking the same language can expect to be particularly effective in this objective. Safely navigating opioid prescribing for chronic pain demands excellent clinical skills to reliably calculate morphine milligram equivalents AND communicate effectively communicate with patients to create a commitment to shared decision making. A visual practice tool can help to facilitate understanding and communication in this increasingly complex and challenging area.
Continuing Professional Development, Faculty of Medicine, University of Toronto
Dr. Sud is Academic Director of Safe Opioid Prescribing and has a played a key role in the initial and ongoing development of the course. A graduate of Yale University and the University of Toronto, he is a community-based family doctor and also has a community practice in comprehensive chronic pain medicine. He has played an active role in advocating for comprehensive and effective solutions for Canada’s opioid crisis and in particular for the role of evidence-informed education in chronic pain and opioid prescribing at all levels of medical training. He is a lecturer at the Department of Family and Community Medicine at the University of Toronto’s Faculty of Medicine.
Friday, November 24
1:15 PM – 2:15 PM
Principal Investigator, Medical Education Consultant
Faculty of Medicine Continuing Professional Development University of Toronto
I am a Medical Education Consultant for the Office of Conitnuing Professional Development at the Faculty of Medicine at University of Toront. I am a veterinarian and graduated from Cornell University with a DVM in 1992. I practiced mixed animal medicine and then companion animal medicine for 10 years. (I describe companion animal medicine to my human health care provider colleagues as a mixture of the complexity of geriatric medicine in a pediatric non-speaking patient.) I received my MHSc in Family and Community Medicine from the University of Toronto in 2005- with a focus on continuing medical education.
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