Grant: CIHR Fellowship

Prescription opioid (PO)-related harms constitute a major public health problem in Canada. In addition to the problems of opioid addiction, the misuse of PO medications has been shown to contribute to fatal overdose mortality rates similar to the rate of death from motor vehicle accidents. There are also growing concerns over possible diversion of these medications to the illicit marketplace. Due to the dramatic rise in PO prescription rates seen in Canada, rigorous scientific research aimed at addressing PO-related harms is urgently needed. My proposed research with Dr. Evan Wood (a Tier 1 Canada Research Chair at the University of British Columbia), with support from Dr. McCarty (Principal Investigator of the National Institute on Drug Abuse Clinical Trials Network Western States Node), aims to examine the impact of unsafe prescriptions for opioid medications on health service utilization and related harms among people who use illicit drugs in Vancouver. Specifically, I hypothesize that unsafe prescription opioid prescribing will be associated with various health harms (e.g., overdose, HIV infection), and will result in higher rates of hospital (re)admission and length of stay. In addition, I will design, pilot and evaluate an innovative opioid stewardship program (OSP), which will be modeled after successful antibiotic stewardship programs, with the aim to decrease opioid-related harms and improve patient safety. I hypothesize that an OSP will be associated with a reduction in rates of unsafe opioid prescribing and opioid diversion. Findings from my program of research are expected to inform public health efforts to minimize the health harms associated with inappropriate prescription of opioids in Canada and internationally.