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Opioids Clinical Primer

Additional resources for the Opioids Clinical Primer program.

Additional Supports and Services

Academic Detailing
Educational outreach utilizing one on one pharmacist visits to providers to assist with optimizing clinical care.
MyPractice Reports
Primary Care report: confidential opioid prescribing information about your own practice in relation to your peers across the province.
OMD Educates
A 10-part series of online learning, OMD Educates: Digital Health and Virtual Care Curriculum.
Ontario eConsult Program
Through a secure, web-based platform requesting providers can ask a pain medicine specialist a clinical question about their patient’s pain management and receive advice quickly (usually within 2 days).

Clinical Tools

Checklist for the Medical Assessment of the Patient Asking About Medical Cannabis
The Canadian Consortium for the Investigation of Cannabinoids has developed the Checklist for the Medical Assessment of the Patient Asking about Medical Cannabis, a fillable form intended to be a reference tool for the evaluation of a patient for medical cannabis by a health professional.
HARMS Program Case-Based E-Learning Modules
The cases in the HARMS Program learning modules are based on real cases and were specifically chosen to illustrate key principles when using urine drug testing in a primary care setting for chronic non-cancer pain.
Motivational Interviewing Basics (CAMH)
This guide developed by the Centre for Addictions and Mental Health (CAMH) reviews the basics of motivational interviewing, including the spirit, principles, foundational skills and includes 'Quick Tips' for practitioners.
National Pain Centre Resources
A useful list of documents and links from the National Pain Centre including Pain and Addiction Education Programs, Tools and Resources for Prescribers; as well as a listing of Canadian Pain Clinics.
Opioid Manager (Centre for Effective Practice)
Supports health care providers prescribe and manage opioids for patients with chronic non-cancer pain through succinct information, with fillable appendices that can be inserted into the patient chart.
Opioid agonist therapy decision aid tool
A tool for patients to use with their health care providers to help them decide what opioid agonist therapy (OAT) option would be best for them: sublingual buprenorphine (Suboxone), depot buprenorphine (Sublocade), methadone, or slow-release oral morphine (Kadian).
Toolkit for alcohol-related presentations to the emergency department
These tools address the effective treatment of alcohol withdrawal, management of other alcohol-related presentations, brief counselling interventions, initiation of anti-craving medications, and referral to community resources.

Continuing Professional Development Opportunities

Opioid Dependence Treatment Certificate Program (CAMH)
The Opioid Dependence Treatment Certificate Program has been developed to prepare physicians, pharmacists, nurses and counsellors to provide a comprehensive range of services for people with opioid dependence.
Safer Opioid Prescribing: A Multimodal Program for Chronic Pain and Opioids (University of Toronto)
This series assists physicians to develop knowledge and skills in the field of pain management, including multi-modal approaches to complex chronic pain, initiating and managing safer opioid therapy, preventing and addressing opioid use disorder, and communication & collaborative practice skills to better manage opioid therapy.

Course Handouts

Opioid Conversion Table - Safer Opioid Prescribing Strategies
This table has been adapted from the Opioid Manager, Centre for Effective Practice (September 2017) and the 2017 Canadian Guideline for Opioids for Chronic-Non-Cancer Pain, National Pain Centre, McMaster University.
Opioid Use Disorder in Primary Care: Principles of Assessment and Management - Course Handout
This handout is designed to complement the course Opioid Use Disorder in Primary Care: Principles of Assessment and Management in the Opioids Clinical Primer CPD Series and includes an overview of opioid use disorder diagnostic criteria and assessment principles; opioid withdrawal symptoms; what to do if you recognize that a patient has an opioid use disorder; options for the treatment of opioid use disorder; and some additional links to supports and key resources.

Evidence, Guidelines and Recommendations

BC’s Guideline for the Clinical Management of Opioid Addiction (2017)
Amidst a provincial overdose crisis, British Columbia made concerted efforts to address gaps in the provision of evidence-based treatment options and care for individuals with opioid use disorder, including the development of provincial guidelines as well as the creation of its aligned training program, the Provincial Opioid Addiction Treatment Support Program.
Buprenorphine/Naloxone for Opioid Dependence: Clinical Practice Guideline
The objective of this guideline is to provide clinical recommendations for the initiation, maintenance and discontinuation of buprenorphine/naloxone maintenance treatment in the ambulatory treatment of adults and adolescents with opioid dependence in Ontario.
Canadian Guideline for Opioids for Chronic Non-Cancer Pain
The Canadian Guideline for Opioid for Chronic Non-Cancer Pain was developed in response to concerns that Canadians are the second highest users per capita of opioids in the world, while the rates of opioid prescribing and opioid-related hospital visits and deaths have been increasing rapidly.
Opioid Wisely
Find 15 specialty-specific recommendations for when the use of opioids should not be first line therapy and information resources to help patients have informed conversations with their clinicians about safe options for managing pain.
Recommendations for the use of slow-release oral morphine as opioid agonist therapy
Bringing together published evidence and both clinical and experiential expertise, these recommendations are intended to guide prescribers in the use of slow-release oral morphine (SROM, brand name Kadian) as opioid agonist therapy (OAT).

Featured Resources

Buprenorphine Reference Guide
This guide has been developed to complement the Opioids Clinical Primer CPD series and includes an overview of buprenorphine/naloxone pharmacology; guidance for initiation, dosing, managing and writing buprenorphine/naloxone prescriptions; and the role of urine drug testing.

Patient-Oriented Resources

META:PHI programs and services (general)
Mentoring, Education, and Clinical Tools for Addiction: Primary Care–Hospital Integration (META:PHI) is a collaborative project to create new care pathways for addiction.
Patient Checklist | Resources for Managing Chronic Pain and Mental Health - Mental Health, Chronic Pain, and Substance Use: Addressing the Connections
This convenient Patient Checklist of self-help resources for managing chronic pain and mental health is a fillable pdf ideal for prescribing various resources to your patients.
RAAM Clinics Finding Tool
A rapid access addiction medicine (RAAM) clinic is a low-barrier, walk-in clinic that patients can attend to get help for a substance use disorder without an appointment or formal referral.