Patient drug history to be scrutinized before narcotics prescriptions

Doctors in Nova Scotia will have to take a closer look at a patient's monitored drug history before writing a prescription for narcotics or controlled substances.

The College of Physicians and Surgeons of Nova Scotia recently approved a new policy to make sure doctors are looking up a patient's history on the province's drug monitoring program, which was made available online in 2012.

"This crystallizes what many doctors realize was already best practice," said Dr. Gus Grant, CEO of the Nova Scotia College of Physicians and Surgeons.

Pharmacists have been submitting prescription information to the online database since 2007. It's the same monitoring program pharmacists use to make sure a client isn't filling the same narcotics prescription twice, or getting the same prescription from different doctors. 

"This makes it quite clear that there's good information out there and that good prescribing should be supported by the best information and that we're saying, 'You have to do this,'" said Grant.

"We can't turn our backs on patients in pain. That's a fundamental responsibility. We have to treat pain."

For Grant, the immediate goal is to make sure doctors prescribe narcotics to patients who need the drugs for pain relief, rather than someone with a drug addiction or who may be looking to sell the substances on the streets.

"We know that many diverted medications come from well-meaning doctors who either weren't trained to say no, didn't feel empowered to say no or in some way were intimidated by the patient," said Grant.

"We want doctors to make the best decision possible. We want them to make the best decision they can in applying their professional judgment and weighing the best information."

According to the province's medical examiner's office, there were 201 opioid-related deaths in the province between 2008 and 2013. Of those deaths, 82 were methadone related. 

The new prescription policy comes into effect June 1.