How e-Prescriptions Can Help Reduce Risk in Opioid Prescribing

By Peter Selby

As the COVID-19 pandemic upends Canadians’ daily lives, a surge in opioid-related overdoses continues across Canada. Nearly 15,400 Canadians died from an opioid-related overdose between January 2016 and December 2019. While 2020 data continues to be analyzed, Ontario’s coroner reported a 25 per cent increase in the number of opioid-related deaths so far this year.

white pills pouring out of bottle onto table

Opioids are a type of controlled medication, along with benzodiazepines and stimulants. These drugs all have therapeutic value, but they can have serious consequences if taken inappropriately. They are highly addictive, have value in the illicit market and can cause serious harm to individuals, families and communities if misused.

To maximize the benefits of controlled medications, while minimizing the risks associated with their use, we need to be able to track their journeys through the health system. By doing so, we can help clinicians and pharmacists ensure that their patients are getting the right medications, in the right dosages, at the right time.

The COVID-19 pandemic has prompted a shift towards virtual care across the health system; virtual visits have enabled patients and providers to stay safe and avoid potential exposure to the virus. While many patients have been connecting to their providers through videoconferencing platforms and the phone, the weak link is the safe and efficient transmission of prescriptions for controlled medications from prescribers to pharmacists. This has led to a heightened interest in e-prescribing.

An e-prescribing service like PrescribeIT® enables secure transmission of a prescription directly from an electronic medical record (EMR) to a pharmacy management system (PMS). Since the PMS receives prescriptions directly, e-prescribing reduces the chance of the prescription being lost, manipulated or diverted elsewhere. Prescribers and pharmacists can also communicate directly within their workflows, posing questions and asking for clarifications, and enabling smoother collaboration within a patient’s circle of care.

Dispense notifications also help clinicians confirm that the correct medication is reaching the intended patient. Pharmacists receive a notification that a prescription has been received; they can also send a notification to physicians when it has been dispensed. In contrast, once a paper prescription leaves the prescriber, it is difficult to ascertain when or whether it has successfully reached the pharmacy. And so, e-prescribing can help enhance medication management, a key aspect of prescribing controlled substances.

Similarly, e-prescribing facilitates the prescribing of smaller quantities of a medication. This can be especially helpful when prescribing controlled substances, potentially limiting the opportunity for accidental overdoses. By ensuring that patients will have access to the medication they need, when they need it, e-prescribing can also help prevent the stockpiling of medication — reducing the risk of its diversion or intentional overdose.

The COVID-19 pandemic has exposed opportunities to modernize health care, including our prescribing practices. If we want to facilitate the safe, modern management of controlled medications, we need safe, modern tools. Prescribing through PrescribeIT® is just one opportunity to make a real difference for our health system — and for the patients it serves.

If you are considering signing up for PrescribeIT®, or if you would simply like to learn more about the service, please visit

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About the author
Peter Selby

Peter Selby

Dr. Peter Selby is Professor, Division Director, Mental Health and Addictions, and Clinician Scientist in the Department of Family and Community Medicine, with cross-appointments in Psychiatry, and the Dalla Lana School of Public Health at the University of Toronto. He is a Clinician Scientist in the Campbell Family Research Institute and Senior Medical Consultant at Toronto’s Centre for Addiction and Mental Health. His research focuses on innovative methods to understand and treat addictive behaviours and their comorbidities.