High Dose Opioid Prescribing Review

The Manitoba Monitored Drug Review Committee (MMDRC) is an advisory committee of experts established by the Manitoba Government in 2013. Members are appointed by the Deputy Minister of Health. The MMDRC reviews the prescribing, dispensing and utilization of narcotics, benzodiazepines and other drugs selected for monitoring.

In 2018, based on advice from the MMDRC, Manitoba Health Seniors and Active Living’s Provincial Drug Program referred to the CPSM a list of prescribers who were prescribing > 900 MME/day to at least one patient in the second quarter of 2018. This data, although concerning, was incomplete due to a lack of accompanying clinical/chart information. The CPSM elected to gather more detailed information regarding each case, to determine appropriate further steps. This information gathering process is currently in its early implementation phase.

Planned CPSM Approach to MMDRC Referral of High Dose Opioid Prescribing Data (>900mme/day):

•  Each prescriber on the list will receive a letter from the Registrar explaining the current context of the opioid crisis and emphasizing that the intent of the review is educational. Detailed case information will be requested.
• Based on the information received, the Registrar will have the following options: an educational letter to the prescriber, a referral to standards or investigations. The latter will only occur if the physician does not participate or refuses to engage in reflective practice change over time.