The College of Physicians and Surgeons of BC has adopted a new professional standard, Safe Prescribing of Drugs with Potential for Misuse/Diversion, to assist physicians with prescribing opioids, benzodiazepines, and other medications. Many of the principles contained in the new standard reflect the US Centers for Disease Control and Prevention’s (CDC) Guideline for Prescribing Opioids for Chronic Pain – United States 2016, which the Board of the College of Physicians and Surgeons of BC endorsed in April 2016.
The document contains both professional standards, which must be adhered to, as well as recommendations for physicians to consider based on their patients’ situation and their own clinical judgment.
Specifically, the document directs physicians to have documented discussions with their patients about the benefits of nonpharmacologic and non-opioid therapies for the treatment of chronic pain. If a risk-benefit analysis indicates that opioid therapy is appropriate, then physicians are cautioned to avoid prescribing opioid pain medication and benzodiazepines concurrently, and to prescribe the lowest effective dosage with ongoing reassessment of the patient, including routine urine testing.
The document further directs that physicians review a patient’s medication history on PharmaNet (when access is available) before prescribing opioids, sedatives, or stimulants. If access is not available, physicians are expected to consult with colleagues, including pharmacists, and prescribe only necessary medications until the patient’s dispensing history is available.
Safe Prescribing of Drugs with Potential for Misuse/Diversion is available on the College website at www.cpsbc.ca/files/pdf/PSG-Safe-Prescribing.pdf. It replaces an earlier document that outlined precautions in prescribing opiates, Prescribing Principles for Chronic Non-Cancer Pain.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
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For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org