Opioid prescribing—a matter of ethics

I was deeply disappointed that the editors of Canadian Family Physician felt that Dhalla and colleagues’ paper on opioid prescribing¹ should be relegated to online-only status. From an ethical perspective, this is one of the most important issues for family physicians in Ontario. In medicine we often fail in our duty to help our patients as much as we ideally should; sometimes we even make honest mistakes that result in adverse patient outcomes. Opioids are different. Through overprescribing—in frequency, dosage, and amount—physicians, often family or emergency room doctors, actively harm thousands, if not millions, of patients, causing dependence, addiction, and myriad other social and physical harms. It not only wastes countless physician hours and drug dollars, but also costs many patients and their families (including a substantial number of teenagers) their emotional and physical well-being and, increasingly, their lives.

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