Opioid Stewardship Program
Prescription opioid misuse and dependence has become an increasing problem and is linked to an array of negative consequences including addiction, overdose, and mortality. Although most chronic opioids are prescribed in the community, use in hospital and on discharge significantly increases the risk of chronic use and is often the first point of use for previously opioid naïve patients. While the use of high dose opioids in hospital can increase the risk of adverse events and length of stay, untreated pain continues to remain an issue for many patients, and finding the balance of managing pain while using opioids as safely as possible remains an ongoing struggle.
The Opioid Stewardship Program at St. Paul’s Hospital is a systems-level intervention developed to address this ongoing gap in care. Implemented in January 2020, the opioid stewardship clinical team consists of a clinical pharmacy specialist and addiction medicine physician who review and assess patients throughout the hospital and provide recommendations to improve the use of opioids. The program also addresses system wide prescribing through education, review of hospital policies and order sets, research, and quality improvement projects.
The goal of the Opioid Stewardship Program is to improve opioid prescribing, utilization, and monitoring at SPH in order to prevent or reduce adverse events, risk of inappropriate long-term use and dependence, and improve or maintain adequate pain control.
What started as a pilot project through partnership between Providence Health Care and the BC Centre on Substance Use, the Opioid Stewardship Program is now a permanent fixture at St. Paul’s Hospital thanks to funding and support from the Department of Medicine.