Initiatives to Address Problematic Prescription Drug Use

Initiatives to Address Problematic Prescription Drug Use (Budget 2014) : $44 million 2014-2019
Initiatives Funding (2014-2019) Status/Achievements

Increase pharmacy inspections to help reduce the diversion of prescription drugs.

$13 million

In 2015, Health Canada announced that it would conduct 1000 compliance promotion inspections in community pharmacies across the country by 2019. 100 inspections were planned for fiscal year 2015-16 and 300 per year are planned for 2016-17, 2017-18 and 2018-19.

In 2015-16, 232 pharmacy inspections were completed, and as of February 2017, 93% of 556 planned pharmacy inspections had been completed for 2016-17.

The objectives of the community pharmacy inspection program are to:

  • promote compliance with the Controlled Drugs and Substances Act and its regulations
  • strengthen cooperation and communication between Health Canada, pharmacists and their provincial authorities and associations
  • facilitate national information sharing to address the diversion and problematic use of prescription drugs

Enhance access to prevention and treatment capacity for problematic prescription drug use within First Nations communities across Canada.

$13.5 million

Funding to address problematic prescription drug use has been distributed to First Nations communities, Tribal Councils and treatment centres. This funding targets case management and critical supports, and prevention training activities for service delivery workers in select communities. Also, a crisis intervention team located in Saskatchewan and Manitoba is being led by the Opaskwayak Cree Nation and the College of Physicians and Surgeons of Saskatchewan. They bring additional support to targeted communities receiving support from First Nations and Inuit Health Branch regional offices.

Conduct a national marketing campaign aimed at parents and youth.

$6.9 million

Funding was provided for a 5-year campaign to raise awareness in regards to harms and the importance of proper monitoring, storing and disposing prescription drugs.

Launched in October 2014, the problematic prescription drug use campaign informed parents of youth aged 13 to 15 about the rising problem of problematic prescription drug use and its associated risks among teenagers. The campaign's first 3 years have included a mix of traditional and new media marketing, advertising and outreach tactics, such as:

Health Canada is continuing to develop and refine marketing tactics and activities for the final two years of the campaign, and will focus and address emerging issues, such as opioids.

Support research on new clinical and community-based interventions for preventing and treating problematic prescription drug use.

$12 million ($5 million in new funding was announced in Budget 2014)

Through the Canadian Institutes of Health Research (CIHR), the federal Government established, in 2014, a national consortium on problematic substance use called the Canadian Research Initiative in Substance Misuse (CRISM).

Through CRISM, CIHR established four research nodes across Canada (British Columbia, the Prairies, Ontario, Québec/Maritimes) to create a strong platform for research on substance misuse with a stable infrastructure that connects research experts, healthcare systems and knowledge users (affected individuals/organizations), with public health and policy.

Through CRISM, CIHR also supported a national randomized controlled trial (OPTIMA Study) to compare and evaluate the safety and efficacy of two treatments for prescription opioid dependence:

  • methadone, which is the current standard of care in Canada
  • buprenorphine/naloxone, often the therapy of choice in the United States

The comparison of the effectiveness of the two treatment models in reducing prescription opioid use will generate practice-based evidence that will be used to inform patient care and improve overall health outcomes.

In June 2016, CRISM researchers published a report in which they made evidence-based recommendations to ease access to buprenorphine/naloxone, a safe and effective alternative to methadone for the treatment of opioid addiction.

On February 7, 2017, CRISM researchers published evidence-based guidelines for the Government of British Columbia (BC), all BC physicians, nursing and allied health professionals, and other care providers involved in the treatment of individuals with opioid use disorder. CRISM researchers are currently working on adapting these guidelines at the national level.

Strengthen surveillance and data collection with a pan-Canadian approach for the monitoring and surveillance of prescription drugs.

$4.28 million

The Canadian Institute for Health Information (CIHI) has received funding to coordinate a pan-Canadian approach for the monitoring and surveillance of prescription drugs, including the data reporting standards necessary to establish a national network of coroners' reports to better understand the impact of opioids on death rates in Canada.

Develop evidence-based practices for appropriate prescribing.

$388 thousand to support the Prescription Monitoring Program Network

Allocation of $4 million of existing funds from 2015-17 to fund six projects

In 2014, Federal, Provincial and Territorial Health Ministers established a Prescription Monitoring Program (PMP) Network with a mandate to help share information and best practices to establish and further develop PMPs across Canada. To date, the Network has primarily focussed on evaluating current PMPs and identifying best practices.

The following 6 projects are funded under Health Canada's Substance Use and Addictions Program:

  1. McMaster University is updating the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain, which will inform prescribers of current strategies and best practices in prescribing opioids. This project also involves developing e-tools for prescribers, train-the-trainer modules, face-to-face delivery and tool kits that will be disseminated through appropriate networks across Canada.
  2. The University of Waterloo's School of Pharmacy is targeting physicians, pharmacists and students in medicine and pharmacy. They are developing and implementing a collaborative, web-based education program focused on adherence to opioid guidelines.
  3. The Canadian Association of Schools of Nursing is developing prescriber practice competencies for controlled drugs and substances for nurse practitioner and registered nurse education programs. Also being created is an e-resource for nursing faculty to facilitate the integration of the competencies into curricula.  These tools will inform nurses and faculty on current strategies and best practices.
  4. L'institut national de santé publique is developing tools for prescribing physicians in Quebec to better understand the prescribing habits and needs required to improve opioid drug prescription practices and training.
  5. The Toronto Rehabilitation Institute's University Health Network (UHN) is developing opioid self-assessment tools for family physicians using the revised Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain. UHN is also creating a web-based interface that will allow Opioid Manager, a point of care tool for providers prescribing opioids for chronic non cancer pain, to interface with Electronic Medical Records. These tools will aid in improving Canadian family physicians' knowledge and performance in the safe prescribing of opioids.
  6. The Institute for Safe Medication Practices Canada is improving Clinical Decision Support Systems for Electronic Medical Records and Non-Electronic Medical Records, to assist physicians and other health professionals with decision-making regarding the introduction and management of opioid therapy.
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