Safe Prescribing of Drugs with Potential for Misuse/Diversion was developed over the past year as an evolution to a previous document entitled Prescribing Principles, which failed to prevent an increasing toll of prescription drug misuse and overdose deaths in this province. The decision to reframe what is essentially the same advice as a standard rather than a guideline was based on what the College saw as a need to provide more authoritative direction to the profession in the context of Dr Perry Kendall’s recent description of BC’s health care emergency of opioid misuse and overdose.

The authors write that the professional standard does not explicitly make an exception for active cancer, palliative, and end-of-life patients. In fact it does, but perhaps greater clarity or emphasis on this point would be helpful when the standard is next reviewed.

The College does not accept that the professional standard in any way fails to account for the welfare of patients with mental illness or contributes to the stigmatization of these patients. A large part of the impetus to provide more authoritative direction for safe prescribing was evidence before the College—that it is often patients with concurrent diagnoses of mental illness or addiction who are the victims of the adverse and sometimes fatal side effects of inappropriate long-term opioid treatment.
—Gerrard A. Vaughan, MD
President, College of Physicians and Surgeons of British Columbia
—Heidi M. Oetter, MD
Registrar and CEO, College of Physicians and Surgeons of British Columbia