Core principles for safe and effective prescribing are set out in the College professional standard Safe Prescribing of Opioids and Sedatives, and approved by the Prescription Review Panel. These principles are intended as a guide for physicians to ensure safe, judicious and responsible prescribing to all their patients. The College recognizes that opioid therapy will be different when treating pain in the settings of active cancer treatment, palliative care and end-of-life care.
The College does expect appropriate pharmacovigilance in the prescribing of controlled drugs.
Prescription Review Program Staging Process
The program begins with a review of the physician’s PharmaNet practitioner prescription profile, followed by several stages of educational activities.
At each stage, a PharmaNet practitioner prescription profile is reviewed by the medical consultant. Depending on the unique situation of each case, files may progress linearly stage by stage, go back and forth between stages, or may be accelerated through the program. If the review reveals prescribing patterns that are consistent with the College standards and guidelines, Safe Prescribing of Opioids and Sedatives, the panel would likely direct that the file be closed.
For those physicians with particularly challenging prescribing profiles, a face-to-face discussion with a medical consultant is offered as an opportunity to discuss barriers to, and opportunities for, improvements in prescribing practice. The educational and remedial activities provided by the PRP are of a collegial nature, supported by research and best practices.
Continuing Medical Education
Family physicians consistently rate prescribing for chronic pain amongst the most difficult areas of their professional lives. In a discipline where communication is the core skill set, talking to patients in realistic terms about the risks and benefits that attend the use of opioids, benzodiazepines and other potentially habituating medications challenges even the most seasoned practitioners. Participants in this intensive course will learn new approaches, primarily though interview simulations in small groups, supported by sympathetic, experienced, clinical teachers.
For more information, please visit the events page.
Chronic Pain Management Conference
Chronic Pain Management Conference
Presented by the Foundation for Medical Excellence in cooperation with the College of Physicians and Surgeons of British Columbia. This course is designed to assist clinicians in managing the most challenging of pain patients—those with complex chronic pain.
For more information, please visit the events page
For a list of safe opioid prescribing courses recognized by the Prescription Review Program, please contact 604-733-7758 extension 2629.
- Recommended Resources from Drug Programs
- Safe Prescribing Tool Kit
- RxFiles: Opioid and Pain Related Links
- Choosing Wisely Canada resources
- Michael G. DeGroote National Pain Centre at McMaster University
- Opioid Manager (point-of-care tool)
- The Pharmacists Clinic at UBC
- Navigating Opioids for Chronic Pain
- Essential Clinical Skills for Opioid Prescribers
- Sample Pain Treatment Agreement
- Narcotic Log: Narcotic and Controlled Drug Administration and Purchasing Record
The 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain
- National Guideline
Recommendations for clinical practice from an international team of clinicians, researchers, and patients
Patient information on tapering, opioid manager, and switching opioids form
Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain
- CDC Guideline for Prescribing Opioids for Chronic Pain
Guidelines for primary care providers who treat chronic, non-cancer pain in an outpatient setting, to ensure safe prescribing
- Guideline Resources
Quick reference tools to supplement the CDC guidelines and assist prescribers in making treatment decisions, and communicating with patients
- New England Journal of Medicine: Reducing the Risks of Relief — The CDC Opioid-Prescribing Guideline
US Department of Veterans Affairs and Department of Defense Guidelines
- Clinical Practice Guideline for Opioid Therapy for Chronic Pain
- Clinician Summary (contains algorithms to guide decision-making)
- Patient Summary
- Patient Information Guide: Long-term Opioid Therapy for Chronic Pain
American Society of Interventional Pain Physicians Guidelines
Royal Australian College of General Practitioners Clinical Guidelines
- Prescribing drugs of dependence in general practice, Part A: Clinical governance framework
- Prescribing drugs of dependence in general practice, Part B: Benzodiazepines
Canadian Family Physician Clinical Practice Guidelines