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 [9]. It replaces an earlier document that outlined precautions in prescribing opiates, Prescribing Principles for Chronic Non-Cancer Pain.