Can online training uplift opioid sparing strategies?

Opioid analgesic prescribing has been in trouble for decades in North America. Things are changing, though. Still, there’s room to adjust care, especially new starts.

A new study published in the Family Practice found better knowledge following an online seminar. The webinar focused on sparing opioid prescriptions to opioid naïve patients in British Columbia, Canada.


Opioid sparing is prescribing the lowest dose of an opioid analgesic for the shortest duration (e.g. <1 week).

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What kind of non-cancer pain are we talking about?

We only talk about individuals not currently taking opioid analgesics. And, those presenting to their prescriber in primary care clinics with pain from new or ongoing non-cancer causes, such as: new or chronic MSK issue (e.g., ankle sprain), mechanical low back pain, osteoarthritic knee pain, rotator cuff pain, dental pain, etc.

How was the training done?

We wanted to find out whether online training improves frontline workers knowledge of opioid prescribing to opioid naïve patients who have noncancer pain.

We partnered on this study with the Therapeutics Initiative and the British Columbia Centre on Substance Use.

Dr Rita McCracken trained 200 frontline workers and staff from September to November 2021.

Four key questions tested their knowledge of opioid sparing before and after the online seminars.

Watch the free webinar recording here:

What did the training uplift or change?

Audit and feedback projects should include co-interventions to try out messages.

We developed a feasible and acceptable opioid-sparing online seminar.

The session helped family physicians understand opioid initiation variability.

Download the webinar handouts at this link:

Think Twice! The (lack of) evidence for opioid analgesics to treat minor acute and chronic pain

An ongoing trial tests the effects of ‘nudge’ letters to cut new starts of prescription opioids. Over 5,000 letters have been sent to family doctors in British Columbia. The researchers will look at the rates of new starts of opioids for non-cancer pain six months later.

Why is opioid sparing important?

There are more than six deaths a day due to drug poisoning in British Columbia. Chronic prescription opioid treatment for non-cancer pain has also the potential to transition to illicit opioid and intravenous drug use. Injecting drugs comes with the risk for overdose and blood-borne infections. More and more people are dying due to counterfeit fentanyl that is a growing crisis in most regions in Canada, with BC accounting for one-third of Canada’s poisoning deaths. The first 10 months of 2021 saw 1,782 illicit-drug deaths which was more than the total for all of 2020.

Reference: Narayan, S., Rizarro, S., Hamilton, M., Cooper, I., Maclure, M., McCracken, R., Klimas, J. (2022) Development and pilot evaluation of an educational session to support sparing opioid prescriptions to opioid naïve patients in a Canadian primary care setting. Family Practice (Online on May 11, 10.1093/fampra/cmac044)

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