Dialogue Volume 12 Issue 2 2016 - Page 23

opioids Regulations intended to thwart abuse of fentanyl patches Bill prompted by fentanyl’s role in rising number of overdoses photo: masterfile T he Ontario government is proposing new regulations that will make it more difficult for patients to abuse or sell their fentanyl patches. A private member’s bill – Bill 33 – Safeguarding our Communities Act (Fentanyl Patch for Patch Return Policy) – requires physicians who prescribe fentanyl patches to participate in a program which is already operating in 45 Ontario communities. Under the Patch4Patch program, patients with a prescription for fentanyl would only be given new patches of the drug when they turn in used patches to their pharmacist. The bill was primarily prompted by fentanyl’s role in the rising number of accidental overdose deaths. Fentanyl has been blamed for 655 deaths across Canada between 2009 and 2014, with most deaths appearing to be the result of valid prescriptions being abused – either by the patient or by someone using the patches intended for the patient. The street price for a fentanyl patch ranges from $200-$300 in southern Ontario and upwards of $500 in First Nations communities in the north. In fact, they are often sold in pieces because of the high cost. Originally developed as an operating room drug, fentanyl is approximately 100 times more potent than morphine and 40 times more potent than heroin. It has been described by the Canadian Guideline for Safe and Effective Use of Opioids as a second line drug for severe pain, and should only be considered if morphine, oxycodone or hydromorphone are not appropriate for the patient. Physicians who prescribe fentanyl patches should be familiar with The Canadian Guideline for Safe and Effective Use of Opioids, which is an evidence-based guideline to help primarycare physicians and specialists safely and effectively use opioids to treat patients with chronic Issue 2, 2016 Dialogue Issue2_16.indd 23 23 2016-06-16 12:26 PM