I found more on the Canadian connection of sharing information and adopting practices.
https://www.painnewsnetwork.org/stories/2018/5/28/when-do-guidelines-become-guidelines
Quote:
When Do Guidelines Become Guidelines?
May 28, 2018
By Marvin Ross, Guest Columnist
Blaming doctors for failing to prescribe to guidelines that did not exist is the latest in the strange research coming out on the use of opioid pain medication.
That was the case for a recent study led by Dr. Tara Gomes, Dr. David Juurlink and others at the Institute for Clinical and Evaluative Studies (ICES) in Toronto, Canada. Both of these authors have a long list of research reports on opioids and Juurlink was one of the central players in the development of the Canadian guidelines for prescribing opioids for non-cancer pain. Juurlink is also a board member of Physicians for Responsible Opioid Prescribing (PROP), which is notorious for their anti-opioid views.
This particular study, called “Clinical indications associated with opioid initiation for pain management in Ontario, Canada,” is published online in the journal Pain. Gomes and Juurlink set out to evaluate prescribing patterns for patients who are “opioid naïve” to see if their prescriptions complied with guidelines adopted in the U.S. and Canada. In many cases, they did not.
“The U.S. and Canadian clinical guidelines for prescribing opioids for chronic non-cancer pain suggest that doctors should avoid initiating opioids at daily doses above 50 MME," Gomes is quoted saying in an ICES press release.............
....................(Update: Mr. Ross has been informed by the editor of Pain that the Gomes study has been revised to clarify to that the CDC and Canadian opioid guidelines were not in effect during the study period.)
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Read the whole article and let us know how this all fits together.
I still feel like all I have is bits and pieces.
Nearly a quarter of all Ontarians newly prescribed opioids received a daily dose exceeding clinical guidelines
https://www.ices.on.ca/Newsroom/News-Releases/2018/Nearly-a-quarter-of-all-Ontarians-newly-prescribed-opioids-received-a-daily-dose
Quote:
May 16, 2018 Toronto
Nearly a quarter (23.9 per cent) of initial opioid prescriptions in Ontario had a daily dose of more than 50 milligram morphine equivalents (MME), exceeding the suggested dose threshold for opioid prescriptions outlined in North American clinical guidelines, according to a new study from the Institute for Clinical Evaluative Sciences (ICES) and St. Michael's Hospital.
"The U.S. and Canadian clinical guidelines for prescribing opioids for chronic non-cancer pain suggest that doctors should avoid initiating opioids at daily doses above 50 MME. Our study found that nearly one-quarter of Ontarians taking an opioid for the first time received a daily dose exceeding this threshold, and for certain indications such as knee, hip and shoulder surgeries and Caesarean sections, the dose was even higher,” says Dr. Tara Gomes, lead author of the study and a scientist at ICES.................
Prescriptions for opioids have increased sharply in the last decade, making Canada the second highest per-capita user of opioids in the world. Furthermore, 1 in 8 Ontarians was dispensed an opioid in 2016, and Ontario has seen a four-fold increase in overdose deaths in the last 25 years, according to earlier research by Gomes.
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I don't see the data collecting people like Tara Gomes as the problem for what's going on in hospitals and doctor's offices, it's the people/organizations combining data incorrectly and forming false conclusions that are the culprits.