PharmaNet data used to crack down on opioid overprescription

The B.C. College of Physicians and Surgeons says it is working to stop the overprescription of opioid painkillers by focusing on individual doctors with high prescription rates rather than geographical hotspots.

Dr. Ailve McNestry, the deputy registrar for the college, says the college uses data from the provincial PharmaNet database to identify doctors with the highest prescription rates for certain powerful drugs like fentanyl, oxycodone, morphine, and hydromorphone might be overprescribed.

• Overprescription of opioids linked to overdose deaths in B.C.

They then bring in the doctors for training and follow up with check-ups afterwards.

"We have an education review program that enrolls two or three hundred doctors at anytime and those doctors are put into a sequence of interventions. We write to them. We provide them with educational material. We bring them in for face to face interviews," she told CBC Radio on Thursday morning.

"We send them to courses and we continue to provide them with their PharmaNet prescribing information which shows to them exactly what it is that they are prescribing. It gives them a mirror to look at themselves in."

Overprescription hotspots

McNestry was responding to a UBC study released yesterday that found a link between the overprescription of strong painkillers such as fentanyl, oxycodone, morphine, and hydromorphone in some parts of B.C. and higher rates of overdose deaths from the opioid drugs.

They found significant variation in prescription rates, with the highest levels on the Sunshine Coast, Fraser Valley, Southern Okanagan and Columbia Valley regions.

They then compared the prescription rates with overdose deaths recorded by B.C. Vital Statistics, and found the highest overdose death rates were in parts of the Fraser Valley and the southern Interior of B.C.

• Overprescription of opioids linked to overdose deaths in B.C.

McNestry said the new data provided interesting insights into the problem.

"I wouldn't say we have focused on any particular geographical areas. That is why this information is interesting to us."

The college also use national guidelines to advise doctors on what drugs might be abused, and advises doctors to check the identity of any new patient and PharmaNet records to see what prescriptions the patient has recently received, before prescribing the powerful opioids.

"The PharmaNet database is such a valuable resource that probably all physicians should be using it all of the time in treating this kind of patient," said McNestry.

But she notes use of the database is only currently required for doctors working in transient settings and methadone clinics.

She says they are also taking with the College of Pharmacists on how they can collaborate on the problem.