New N.L. program aims to curb 'questionable prescribing' of opioids

A new program aims to cut down on the "questionable prescribing" of certain drugs, like opioids, according to Newfoundland and Labrador's health minister.

"For example, the program will automatically flag whether a person has visited multiple physicians or pharmacies to get more opioids," said John Haggie at a news conference Wednesday.

The intention of this is not to police those professionals, but rather to educate.- Health Minister John Haggie

"The purpose is to help make informed decisions."

Haggie said the program will also have certain measures in order to curb "very dubious" prescriptions.

"The intention of this is not to police those professionals, but rather to educate," Haggie said.

"It's to give prescribers and dispensers access to information about their patients. This will then assist them in making the best possible healthcare decisions for those patients."

Clear picture of practices

Haggie indicated the new legislation is also partly to allow doctors to examine some of their own decisions when it comes to opioid prescriptions.

"Prescribers will also be able to get a clear picture of their own prescribing practices. That will give them the opportunities to improve or make changes to align with best practice in their peer group," he said.

Haggie said there are two trends when it comes to opioids: an excessive use of those drugs in general and another "much smaller group."

"It really is a very small group which are prescribing in ways that could be regarded as professional misconduct or very dubious," he said.

Prescription info can be shared with police

If the new program becomes law, information about prescriptions can be shared with law enforcement if there are reasonable grounds that a crime has been committed.

"The bulk of the people in this province both patients, prescribers and dispensers are law-abiding citizens who really are not the source of the problem," Haggiesaid.

The program, which will receive second reading in the House of Assembly Wednesday, was developed with multiple groups, including provincial regulatory bodies, law enforcement, community partners and several provincial government departments, according to Haggie.

Medical association has concerns

The Newfoundland and Labrador Medical Association says it's supportive of the aims of the new act similar prescription monitoring exists in every other province except Quebec but it has concerns.

"Theremaybeanunintendedconsequenceofsomeofthe provisions that may drive physicians away from the prescribing of opioids," said Robert Thompson, executive director of the NLMA.

It's also concerned that inspectors will be able to enter offices to investigate whether the act is being followed and copy patient records without any evidence of wrongdoing.

The new rules will require doctors to check a provincial database to review all drugs that have been prescribed to a patient before prescribing an opioid. That is designed to catch addicts who may get multiple prescriptions from multiple health care providers.

Right now less than half the doctors have access to that database. By next year all of them will have to be use the service, which requires only a computer with an internet connection

"We have to train physicians on how to use it efficiently and it has to be efficient in every context in which a physician operates," said Thompson.

"So for example, it is not just the office of a family doctor. It could be a post-operative clinic. It could be at a hospital bedside in an examining room."

If approved, most of the regulations would take effect Jan. 1, 2018.