Canada's National Guidelines for Safe Use of Opioids Recommends Addiction Risk Screening and Continuous Monitoring

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Guidelines incorporate Inflexxion's evidence-based practice tools

Canada has taken an important step towards standardizing managing pain when opioids are indicated as a therapeutic component,” says Kevin Zacharoff, M.D., Director of Medical Affairs at Inflexxion.

Canada's National Opioid Use Guideline Group (NOUGG) has released a new national set of guidelines, the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain (http://nationalpaincentre.mcmaster.ca/opioid/index.html), to provide Canada's health care providers with clear, evidence-based guidance regarding the use of opioids to safely manage patients with chronic non-cancer pain.

The NOUGG guidelines have 24 practice recommendations to assist clinicians who are initiating opioid therapy, conducting an opioid trial, and/or monitoring long-term opioid therapy. In addition, the guidelines incorporate practice tools and other resources to support opioid prescribing practices for this specific patient group. These include the Screener and Opioid Assessment for Patients with Pain-Revised Version (SOAPP®-R) and the Current Opioid Misuse Measure (COMM)® (http://nationalpaincentre.mcmaster.ca/opioid/cgop_b_app_b11.html) .

Developed by Inflexxion, the SOAPP is a brief, paper-and-pencil self-report tool that enables health care providers to assess the risk of addiction in patients being considered for opioid therapy. The COMM is a complementary tool for identifying whether a patient, throughout the course of long-term opioid therapy, may be exhibiting aberrant behaviors associated with abuse of opioid medications.

“Canada has taken an important step towards standardizing practices among clinicians with regard to the process of safely and effectively managing pain when opioids are indicated as a therapeutic component,” says Kevin Zacharoff, M.D., Director of Medical Affairs at Inflexxion.

The SOAPP has been shown to be a highly sensitive instrument. In a recent study comparing the sensitivity of a semi-structured clinical interview and three screening tools, researchers found the highest sensitivity for the clinical interview and the SOAPP, followed by the Opioid Risk Tool (ORT) and the Diagnosis, Intractability, Risk, and Efficacy inventory (DIRE) (Pain Medicine, Volume 10, Issue 8, pages 1426-1433).

The release of the Canadian guidelines follows publication last year of ground-breaking evidence-based guidelines for use of chronic opioid therapy in noncancer pain patients in the U.S. (http://www.jpain.org/article/S1526-5900%2808%2900831-6/abstract), developed jointly by the American Pain Society and the American Academy of Pain Medicine. These guidelines also highlight the utility of the SOAPP and COMM tools.

An article introducing Canada's new guidelines is published in the Canadian Medical Association Journal (http://www.cmaj.ca/current.dtl).

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Lara Romanowski
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