College to audit doctors' prescribing practices as Number of Patients on Methadone Triple......

This is going to affect our Canadian friends and fellow Canadian forum members so I thought it was important to post so everyone could be aware.

This comes from the Winnepeg Free Press print edition and the original link is
http://www.winnipegfreepress.com/local/college-to-audit-doctors-prescribing-practices-102841444.html


College to audit doctors' prescribing practices as Number of patients on methadone triples

Physician regulators plan to audit every Manitoba doctor who prescribes methadone to ensure no patient is being put at higher risk of overdose or relapse.

Dr. Anna Ziomek, deputy registrar of Manitoba's College of Physicians and Surgeons, confirmed the regulatory body will examine the prescribing practices of all doctors who have patients on a methadone maintenance program. There are currently about 20 physicians who prescribe methadone, but Ziomek said that will increase over the next year as more doctors are trained to dole out methadone to keep up with the rising demand from opiate addicts.

The number of Manitoba patients on methadone has recently tripled due to the ballooning number of people hooked on drugs such as OxyContin. The synthetic opiate curbs symptoms of withdrawal, but patients must be closely monitored since there is a risk they could overdose or divert their doses to be sold illegally on the street.

Ziomek said the college has no concerns about any specific prescriber, and wants to do the review to prevent any problems before they start.

She said methadone can be a "lucrative business" for physicians and pharmacists, and the college wants to be certain that patients receive quality treatment so they can lead normal, stable lives.

Recently, the college sent a letter to all methadone prescribers after a doctor prescribed an unsafe dose to a new patient. Ziomek said the patient did not overdose, but the dose was much higher than they should have received.

"Obviously if we heard that somebody was unsafe (from the) audit that would need to be reviewed and taken up with an investigation and maybe they're prescribing privileges would be pulled," she said. "But what we're really looking at is education."

Ziomek said the college will likely review patient records in addition to surveying physicians to determine how closely they are monitoring patients, and whether they are offering extra counselling or supports. She said the college will review how a physician is doing six months after they start prescribing methadone, and they may set up a mentoring program to help doctors with difficult methadone patients.

Approaches to methadone vary by clinic and while Manitoba's publicly funded intervention program has a robust network of supports, other community-based clinics do not.

Opiate addicts start off on a very low dose of methadone that is closely monitored and increased slowly over several months until their cravings subside. Patients must drink their daily dose of methadone in front of a clinician until they prove reliable enough to take "carry" doses home with them

"Is it just that I show up and I get my methadone prescription, or is there some counselling, some social support. Are other issues that make these people's lives complicated being addressed?" Ziomek said.

Medical experts recently said they are keeping a close eye on methadone-related deaths after an increase in the number of accidental overdoses involving the synthetic opiate last year. Data from the Chief Medical Examiner's office shows 19 Manitobans died following an accidental methadone overdose last year -- up from the 13 deaths reported in 2008 and 2007.

jen.skerritt@freepress.mb.ca


Republished from the Winnipeg Free Press print edition September 14, 2010 B2