Case 4 : Opioid Crisis in the Windsor-Essex Community: Time for Responsible Opioid Prescribing?
Canada is in the midst of an opioid crisis, with the number of opioid-related harms and overdose cases increasing rapidly over the past few years. The opioid crisis involves a rising number of opioid-related deaths and overdoses, either from prescription opioids or from the increased availability of illegal, adulterated forms of potent opioids such as fentanyl. Today, fentanyl and fentanyl analogues have been reported to be the major drivers of the opioid crisis in the country, accounting for approximately 73% of accidental opioid-related deaths. Opioid-use disorders are increasingly prevalent in patients with chronic pain who have received opioids for management of their condition. Canadians are often overprescribed opioids for chronic pain conditions, which has, in part, led to the higher number of opioid addictions in the country. Unfortunately, with the increase in opioid-related harms across Ontario, the burden of opioid use in the Windsor-Essex region has increased even faster than in other regions in the province. In response to the growing opioid crisis in the Windsor-Essex community, a multipronged initiative - the Windsor Essex Community Opioid and Substance Strategy - was developed and adopted to address the increases in opioid-related harms in the county. As a result of the increasing number of opioids prescribed by healthcare providers in Windsor-Essex County, and after consulting community partners and key stakeholders, it was decided that educating patients about opioids and supporting healthcare providers through appropriate opioid prescribing practices should be the main components of the strategy. Enhancing the education of health care providers has been identified as a key strategy to prevent opioid addiction and overdose in Ontario. To implement the healthcare providers’ education program, it is important to gather information on the best practices and guidelines for opioid prescribing, and to understand healthcare provider knowledge/knowledge gaps in relation to best practices. This will inform the planning and development of tools and resources for educating patients and healthcare providers on opioid use and chronic pain management.
- Understand the state of current knowledge about the prevalence of opioid use within Ontario.
- Describe the goals and objectives of the four pillars of the Canadian drugs and substances strategy.
- Demonstrate evidence-based planning skills and strategies to develop action plans for a healthcare provider education program.
- Discuss the importance of community engagement and communication in addressing the multifaceted problem of the opioid crisis.
- Describe the role of quantitative, qualitative, and/or mixed-methods research in understanding and evaluating population health and service provider perspectives by reviewing data for needs assessments and program evaluation.
Case Study Questions
- Summarize the current state of knowledge about the opioid crisis in Ontario.
a. What is the significance of the issue?
b. Why should opioid prescribing be considered as a priority for addressing the issue?
c. What are the unintended consequences of adopting the guidelines for opioid prescribing?
- Explain the critical importance of evidence in the planning and implementation of an education program for healthcare providers.
- Discuss your proposed plan for implementing the program based on the priorities set by the health care provider working group.
a. Review the best practices and sources of data used.
b. Understand healthcare providers’ perspectives and knowledge about best practices on opioid prescribing through appropriate use of research methodologies.
c. How would you use the evidence generated to develop tools and resources for educating health care providers and patients about opioid use and prevention?
Best practices, health care providers, opioid crisis, opioid prescription, pain management, patient education
Deb, D., Dupuis, N., Nadalin, E., & Speechley, M. (2020). Opioid Crisis in the Windsor-Essex Community: Time for Responsible Opioid Prescribing? in: McKinley, G. & Speechley, M. [eds] Western Public Health Casebook 2020. London, ON: Public Health Casebook Publishing.