News Release Embargoed until Monday, July 15, 2024, 12:01 a.m. ET
CMAJ headlines:
- Optimizing opioid prescriptions after the ED to reduce opioid overdoses, misuse
- Health research on South Asian communities must be led by South Asians
Optimizing opioid prescriptions after the ED to reduce opioid overdoses, misuse
New research aims to help reduce the quantity of unused prescription opioids after emergency department visits and lessen the risk of opioid misuse and overdose. The study is published in CMAJ (Canadian Medical Association Journal).
Overprescribing is linked to opioid misuse and overdose, with household supplies of opioids associated with an increased risk of overdose, as many people do not dispose of unused medications safely. In Canada, more than 7500 people died of opioid overdoses in 2021, and more than 68 000 people died in the United States in 2020 from these drugs.
A team from the Network of Canadian Emergency Researchers conducted a study at 7 emergency departments (6 academic tertiary care hospitals and 1 community hospital) in Quebec and Ontario to determine the ideal quantity of prescription opioids to control pain in patients discharged from emergency departments and reduce unused opioids available for misuse.
“As higher quantities of prescribed opioids are associated with higher quantities of consumed opioids, it is important to adapt opioid prescription practices to patients’ analgesic needs for specific acute pain conditions while minimizing the number of unused opioid tablets that can be diverted or misused,” writes Dr. Raoul Daoust, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Coeur-de-Montréal, and the Department of Family and Emergency Medicine, Université de Montréal, Montréal, Quebec, with coauthors.
The study included 2240 participants, with a median age of 51 years, who were asked in 14-day diaries and follow-up phone interviews if they filled their prescriptions, how many pills of opioids they took (converted to 5 mg morphine per tablet), and if they filled any new prescriptions. Half of participants received a prescription of 16 tablets or more, and 63% of these were not used. Consumption of opioids was low, half of patients consumed fewer than 5 tablets, and consumption varied significantly by type of pain condition.
“The authors suggest that clinicians could adapt prescribing quantity to the specific condition causing pain, based on estimates to alleviate pain in 80% of patients for 2 weeks, with the smallest quantity for kidney or abdominal pain (8 tablets) and the highest for back pain (21 tablets) or fractures (24 tablets), and add an expiry date for use (e.g., 3, 7, or 14 days). Furthermore, since half of participants consumed even smaller quantities, pharmacists could provide half this quantity (partitioning) to further reduce unused opioids available for misuse.
“Opioid prescribing requirements to minimize unused medications after an emergency department visit for acute pain: a prospective cohort study” is published July 15, 2024.
MEDIA NOTE: Please use the following public link after the embargo lift:
Research: https://www.cmaj.ca/lookup/doi/10.1503/cmaj.231640
Media contacts: Clara Meagher, CIUSSS, clara.meagher.cnmtl@ssss.gouv.qc.ca; or Rebeca Myrtil, rebeca.myrtil.cnmtl@ssss.gouv.qc.ca
Health research on South Asian communities must be led by South Asians
Funding agencies in Canada need to review their policies for evaluating research proposals to ensure that South Asian research is conducted by South Asians, write authors in a commentary in CMAJ (Canadian Medical Association Journal).
Much of the health research conducted in Canada on South Asian diaspora communities has historically been marked by unequal power relations, rather than meaningfully engaging and benefitting these communities.
As the largest and fastest growing diverse visible minority in Canada, South Asian communities are diverse in language, culture, religion, migration history, and lived experience. Their health status and needs are equally diverse.
“When South Asian investigators do not lead the research, study findings are open to misguided interpretations that follow colonial bias and false cultural stereotypes, promote experimental bias, and uphold scientific and structural racism,” writes Dr. Gina Agarwal, a professor in the Department of Family Medicine, McMaster University, Hamilton, Ontario, with coauthors. “This extractive practice, whereby the composition of the research team does not reflect the study population, is not uncommon and risks becoming worse as funding agencies and academic journals express interest in research examining and documenting the health patterns, practices, and lived experiences of racialized communities.”
Research teams conducting research on South Asian communities should include South Asian leads, and funders should include South Asian people in reviewing research grants.
“South Asian communities and academics must be meaningfully engaged in a health research process that acknowledges South Asian people as valuable health research leaders with lived experiences and expertise. This process should build accountability, ownership, and best practices in research involving South Asian participants and communities in Canada.”
“A call to stop extractive health research on South Asian diaspora communities in Canada” is published July 15, 2024.
MEDIA NOTE: Please use the following public link after the embargo lift:
Commentary: https://www.cmaj.ca/lookup/doi/10.1503/cmaj.231189
General media contact: Kim Barnhardt, CMAJ, kim.barnhardt@cmaj.ca
Please credit CMAJ, not the Canadian Medical Association (CMA). CMAJ is an independent medical journal; views expressed do not necessarily reflect those of its owner, CMA Impact Inc., a CMA company, or CMA.