Opioids

The Ontario Pharmacists Association recognizes the complexity of the management of chronic pain and the issues surrounding it. As medication experts, pharmacists have an especially critical role to play where opioids are concerned, with regards to safe and responsible dispensing and patient education in order to prevent misuse.

In this section, we have collected resources to inform and assist pharmacists who dispense opioids:

Opioid conversion for chronic non-cancer pain

Addendum regarding OxyContin substitution

Exceptional Access Program (OxyNeo)

Template letters for communicating with prescribers

Additional resources

Opioid Conversion for Chronic Non-cancer Pain

Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain
Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain: Opioid Conversion and Brand Availability in Canada


Close collaboration between all health care professionals involved in opioid prescribing and dispensing is essential. 

Providers are reminded that opioid conversion charts refer to the analgesic strength of oral opioids and not to the psychoactive effects or effectiveness in relieving withdrawal symptoms. Pharmacists should refrain from making any dose conversion recommendations in instances where opioid prescribing is primarily for addiction maintenance and not for purposes of chronic pain management, and particularly where there is no guarantee that the medication is being administered in the form it was intended.

Prescribers and pharmacists are strongly advised to utilize the information provided through the conversion chart, and to collaborate, agree upon, and document any medication conversion necessary so as to identify real or potential factors that are unique to the patient and/or the alternate drug.

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Addendum regarding OxyContin substitution 

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Exceptional Access Program: Forms and information related to OxyNeo 

Some pharmacists have been asking about the Ontario Government’s Exceptional Access Program, and some of the more specific details regarding OxyNeo. The following links lead to important and helpful information:

OHIP Bulletin – Feb. 17, 2012
Service Ontario – Forms – Request for Unlisted Drug Product – Exceptional Access Program (EAP)

Additional Resources

Some further questions and answers by the ministry on the Narcotics Safety and Awareness Act 2010 [Updated October 31, 2011]
Narcotics strategy - list of monitored drugs [Updated November 9, 2011]
OPA consolidated list of frequently asked questions (Last updated December 5, 2011)

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