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Kathryn Rutherford

Kathryn Rutherfordcreated the topic: Improving access to buprenorphine/naloxone to address opioid use disorder: Spotlight on VON

The Victorian Order of Nurses (VON) Chronic Pain Program provides service to the Erie St Clair LHIN and consists of two nurse practitioners (NP), a nurse case manager, two social workers and an administrative assistant. With the evolving landscape of …

5 months ago

Kathryn Rutherford

Kathryn Rutherfordcreated the topic: How do you implement safer opioid prescribing practices? Spotlight on Marathon Family Health Team

Marathon Family Health Team (FHT) has developed andimplemented the HARMS (High-yield Approach to Risk Mitigation and Safety)Program to improve opioid prescribing practices for patients with chronicnon-cancer pain. The HARMS Program has received various …

8 months ago

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  • Kathryn RutherfordContinued: To summarize, I think we could all agree this is a very complex topic. Trying to distinguish someone who is benefitting from opioids in terms of pain, from someone being harmed by addiction – without an objective test to identify either addiction or pain – is incredibly challenging. Our approach is to incorporate as much information as is feasible as we balance the potential risks and benefits in management/safety decisions.

    I know your comments are coming from a good place as you advocate for pain patients, and this voice is important as the societal pendulum is, in my own personal opinion – unfortunately swinging towards the “opioids are bad” side. We cannot forget about people suffering with pain. That said, this is about balance. It was not just for aesthetics that the HARMS logo ying-yang illustrates balance between someone in pain/despair and someone free/happy. This balanced approach is central to the program, and this discussion is an important reminder of how important it is to maintain this balance.

    Thank you once again.
    Sincerely,
    Dr. Ryan Patchett-Marble, MD, CCFP
    HARMS Program Lead7 months ago
  • Kathryn RutherfordContinued from Dr. Ryan Patchett-Marble:

    My apologies, I just saw your comments from a few days ago. A few quick additions. I totally agree with what you say that the 58% is alarming and I actually think that is an overestimate based on how the ministry monitors this (another example of how stats can be misleading!). My understanding is that if someone is on buprenorphine then that does not count as "being on opioids for pain" (since this is in the ministry's eyes only used for opioid agonist treatment for addiction and is not seen as a patient with pain on opioids), so if we switch someone from morphine for example to buprenorphine for pain then that would appear to be someone who was "tapered" and would exaggerate the stats. Our own chart review suggested it was only 2% of chronic pain patients that had their opioids tapered and discontinued.

    Also, I completely agree that communication and support of the patient is critical. UDT should be approached as a tool to complement management and not used as a punitive measure or for intimidation. We're on the same team, with the same goal - minimizing suffering. Thanks again for your advocacy.
    7 months ago
  • Lee FaircloughThank you to both Dr. Patchett-Marble and Wanita Umer for the discourse on this important topic. 7 months ago