Using ICES data to help Ontario communities deal with the opioid crisis
Ongoing public health concerns about opioid-related harms, including overdoses and deaths, has led to changes in drug policy and clinical guideline recommendations. In 2017, Ontario’s Strategy to Prevent Opioid Addiction and Overdose (PDF) included a policy to remove a class of opioids deemed to be high-strength and long-acting (for example, fentanyl, morphine and hydromorphone) from the Ontario Drug Benefit formulary. The policy was revised with analyses done at ICES in partnership with the Ontario Drug Policy Research Network (ODPRN). The revisions included changes to the use of these high-strength, long-acting opioids specifically in end-of-life care, responding to the need expressed by the palliative care community and patients. The policy was further modified to allow nurse practitioners to prescribe controlled drugs and substances, a change applauded by stakeholders.
In 2018, using data from ICES, the ODPRN released the Ontario Prescription Opioid Tool, an interactive, web-based tool that provides public access to information about opioid and naloxone prescribing in Ontario from 2012 to the present, with quarterly updates. Prior to the tool’s release, webinars were held to get stakeholder input from Public Health Units, Local Health Integration Networks and other organizations. Based on the feedback from these stakeholders, the tool was refined to include indicators that would be useful for informing local strategies that target safe and appropriate opioid use in Ontario.
How this work is having impact
Increasing Capacity for Timely Response
- The delisting policy has been evaluated every six months since it was announced and implemented to inform better alignment of the policy with a tailored response to the opioid crisis on a regional level.
- Ontario’s Public Health Units continue to request updated or additional analyses from ODPRN and ICES to inform their regional programs and strategies.
- This research is informing the development of educational and training materials for naloxone programs, along with the Community Drug Strategy for the implementation of these programs, and the expansion of existing programs. For example, in July 2018, the Toronto Police Service announced that its officers would carry naloxone.
- In 2017, the Office of the Chief Coroner for Ontario started the Opioid Investigative Aid, which captures detailed information around the circumstances of opioid-related mortality. This ensures that timely and real-world data are available to inform this research and various strategies aimed at addressing the opioid crisis.
Engagement with People with Lived Experience
- This program of research is regularly engaging with patients with lived opioid experience to gain their perspectives and understanding of emerging priorities.
Strong Engagement among Health Units
- In 2019, the team hosted a webinar to demonstrate the capabilities of the prescription opioid tool. Over 200 representatives attended from various stakeholder groups, including Ontario Public Health Units and LHINs, Health Canada, the Registered Nurses Association of Ontario, the Centre for Addiction and Mental Health, and the Canadian Centre on Substance Use and Addiction.
- In its first nine months online, the prescription opioid tool was viewed more than 14,000 times. Public Health Ontario has highlighted the tool’s usefulness and will include the tool as a resource at an integrated workshop.
Posted December 2019
Published in the 2018-19 Annual Report
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