Re: WorkSafeBC’s multimodal approach to chronic noncancer pain management. Authors reply

The authors acknowledge that the current public health crisis—the opioid epidemic—is complex and multifactorial, and that prescribing patterns are not the only factors, but that they do represent one aspect of the opioid crisis.[1] The authors outlined some descriptive epidemiology of the current public health crisis of opioid overdose deaths, understanding that the current epidemiology itself is complex and that the response to the epidemic requires a multifaceted approach. Acknowledging that medical literature supports that long-term use of opioids typically yields few long-term improvements in pain and function,[2] the article aimed to introduce multimodal approaches for patients with work-related or non-work-related chronic noncancer pain, to introduce the WorkSafeBC physician hotline for community prescribers (who manage patients with chronic noncancer pain), and to inform community physicians of a teaching module developed by WorkSafeBC that delivers educational outreach to community physicians in supporting their patients with chronic noncancer pain. These evidence-based educational modules available to community physicians, pharmacists, nurse practitioners, and other health care providers provide an evidence-based multimodal approach to pain management for patients and cover both the pharmacologic and nonpharmacologic treatments, the educational materials, and the current College standards on opioid prescribing.[3]
—Peter Rothfels, MD
WorkSafeBC Chief Medical Officer and Director of Clinical Services
—Olivia Sampson, MD, CCFP, MPH, FRCPC, ABPM
WorkSafeBC Manager of Clinical Services

This letter was submitted in response to “Re: WorkSafeBC’s multimodal approach to chronic noncancer pain management.”


1.    National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse; Phillips JK, Ford MA, Bonnie RJ, editors. Pain management and the opioid epidemic: Balancing societal and individual benefits and risks of prescription opioid use. Washington, DC: National Academies Press US; 2017.

2.    Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. MMWR Recomm Rep 2016;65:1-49.

3.    College of Physicians and Surgeons of British Columbia. Practice standard: Safe prescribing of opioids and sedatives. 16 January 2019. Accessed 17 December 2019.

Peter Rothfels, MD, Olivia Sampson, MD, CCFP, MPH, FRCPC, ABPM. Re: WorkSafeBC’s multimodal approach to chronic noncancer pain management. Authors reply. BCMJ, Vol. 62, No. 1, January, February, 2020, Page(s) 12 - Letters.

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