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Opioid hotline provides advice to health professionals

Physicians and nurses can now dial in for answers to difficult questions about prescribed opioid use. Alberta Health Services started the seven-month pilot program on Tuesday as a way to tackle the opioid crisis.

Physicians and nurses can now dial in for answers to difficult questions about prescribed opioid use.

Alberta Health Services started the seven-month pilot program on Tuesday as a way to tackle the opioid crisis.

The advice line is being funded by Alberta Health and will give medical professionals immediate access to information on how to navigate dependency and prescribing opioids for pain.

Dr. Peter Chung, family doctor at Grandin Medical Clinic, says it's challenging handling patients who have developed a dependency on opioids.

"It's quite complex," he says. "How do we help these people that are dealing with addictions and other issues?"

The opioid crisis in Alberta began in 2014 when fentanyl-related deaths skyrocketed. There were 117 deaths, a jump from 66 deaths in the previous year.

In 2015 there were 279 fentanyl-related deaths in Alberta and 363 fentanyl-related deaths in 2016.

From January to May this year there have already been 176 deaths, with 58 fentanyl-related deaths occurring in Edmonton.

Of the 176 deaths 34 were related to carfentanil, an opioid 100 times more potent than fentanyl.

Chung started working as a family doctor at the Grandin Medical Clinic last year, just after graduating.

Since starting at the clinic he says he has already encountered a situation where he needed advice on prescribing opioids.

"I had a patient who was on higher dose opioids from a different physician transferred to me and he had never had to do any urine drug screens. We had sent him for one and he came back positive for cocaine," he says.

"Technically he broke his contract so I could have stopped prescribing but then he would have gone through withdrawals and end up in emergency or turned to the streets to get his medication."

Chung was able to get advice from other doctors at the clinic who have been working there for over 10 years and come up with a new treatment plan.

For those who are freshly graduated and don't have a support network, he says the call-in service could be vital.

"For newer physicians, often we're taking over patients on higher-dose opioids and maybe we're not comfortable," Chung says. "Even with older physicians too, I think it's a good service because standards and guidelines have really changed."

He says prior to the call-in service, family doctors who were uncomfortable prescribing opioids could refer the patient to a pain clinic.

The pain clinic would take over prescribing the opioid and once the patient was stabilized on the drug the patient would be returned to their family doctor.

"But it can take over a year to get into one of these clinics so having a service like this could be helpful," he says.

Joanna Oda, medical officer of health with Alberta Health Services in the Edmonton zone says fentanyl is the leading drug for opioid-related deaths.

She says historically opioid-related addictions began with illicit drug use, such as heroin. However, now it's more common to stem from a prescription.

"Prescribing opioids can be a tricky balance of benefits and harms for front-line health care workers," she says. "You have to treat pain but you also have to balance that with the risks associated with using opioids to manage that pain."

She says the call-in service will help health professionals balance health benefits and risks in prescribing opioids for pain.

For more information on the opioid crisis visit https://www.alberta.ca/albertas-opioid-crisis-response.aspx

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