Opioid Stewardship | ISMP Canada

Opioid medications are used to treat pain. Opioids are also known as narcotics. In recent years more and more Canadians are using opioids, and research indicates that we are now the world's second largest consumer of opioids. Along with this increased use of opioids there has also been a corresponding and alarming increase in the harm from opioids.

Through our ongoing analysis of medication safety incidents, we have found that opioids are frequently associated with harmful consequences-including death-when they are prescribed, used or administered incorrectly or in error.

Opioid Stewardship may be described as coordinated interventions designed to improve, monitor, and evaluate the use of opioids in order to support and protect human health. This web page has been developed to help the public and health care practitioners become better informed about opioids and to help reduce and prevent harm.

Patients and Families

Opioids for pain after surgery
Download: English | French | Acknowledgements

Endorsements: Best Practice in Surgery, Canadian Association of General Surgeons, Canadian Orthopaedic Association, Mackenzie Health, North York General Hospital, Ontario Health, Providence Health Care, Saskatchewan Health Authority, Sinai Health System, University Health Network, University of Toronto, Winchester District Memorial Hospital

Opioids for short-term pain
Download: English | French | Acknowledgements

Endorsements: Neighbourhood Pharmacy Association of Canada, Ontario Health, Saskatchewan Health Authority

Managing pain after wisdom teeth removal
Download: English | French | Acknowledgements

Endorsements: Ontario

Opioid Handout
Download: English | French

Endorsements: Neighbourhood Pharmacy Association of Canada, Pharmasave, Health PEI, Saskatchewan Health Authority

Safe Storage and Disposal Information Card
Download: English | French

Methadone for Opioid Use Disorder
Download: English | French | Acknowledgements

Endorsements: Saskatchewan

Buprenorphine/Naloxone for Opioid Use Disorder
Download: English | French | Acknowledgements

Endorsements: Saskatchewan

Structured Opioid Therapy
Download: English | French

Frequent vomiting from use of cannabis (pot/marijuana) | Acknowledgements
Videos:
- Question Opioids - 2017
- Consumers Can Help Prevent Harm from Opioid Use!: English | French - 2013
Newsletters and alerts:
- Misconceptions about Medicines that Could Be Deadly: What works for me will work for you - June 2016
- Misconceptions about Medicines That Could Be Deadly: It doesn't matter where I keep my medicines - January 2016
- Beware: Medicine Names May Sound Alike, but the Medicines May Be Very Different - March 2015
- Confusion with a Baby's Dose of Medicine - January 2015
- Sharing Opioid Medications Can Be Deadly - September 2014
- Informed Consumers Can Help Prevent Harm from Opioid Use - March 2013
- Take Care with Medicine Patches - July 2012

Prescribing

Opioid Infographic
Download: English | French

Opioid Prescribing Supports:

Morphine Infographic: English | French
Safer Decisions Save Lives: Key Opioid Prescribing Messages for Community Practitioners - ISMP Canada Safety Bulletin
Safe Storage and Disposal of Opioids Factsheet:
- Physician
- Patient

Opioid Prescribing Tools:

Pain Check In: The Pain Check In is a structured approach to information gathering using pre-existing instruments that will give prescribers better information with which to assess the pain patient and engage in collaborative decision making. The tool helps to standardize some of the information collected during pain related visits and addresses a lack of consistency in how clinicians approach pain related visits. The Pain Check In allows the patient to complete a series of paper or electronic forms in the waiting room prior to the visit that can be placed in the paper chart, or EMR. The physician can then review the information in order to facilitate sound decisions about pain management.