TORONTO - Ontario's doctors should be legally required to tell police when they suspect a patient has committed a crime, a new report says.
It's one of 31 recommendations contained in the report released Wednesday by the College of Physicians and Surgeons of Ontario on opioid painkiller abuse.
The report recommends changes in various areas of the health and justice systems and stresses education. Even veterinarians receive more pain management training than physicians, said one of the report authors.
The proposal about reporting to police is aimed at doctors being able to notify authorities when they believe a patient is abusing or dealing opioids such as OxyContin.
But the wording of the recommendation suggests a broader application that would require health professionals to disclose personal information to police if there are reasonable grounds to believe any criminal offence has been committed.
"When health-care professionals, heads of institutions and health information custodians become aware of criminal activity, this information should be shared with the police," the report says.
"There should be a clear and unqualified legal requirement to disclose to a police service."
Dr. Rocco Gerace, the college's registrar, said if a pharmacist called him to say one of his patients has had three OxyContin prescriptions from different doctors filled in the past month, he is currently able to call police.
But the recommendation suggests doctors and other health professionals be mandated to report such situations to the authorities.
Ken Anderson, Ontario's assistant privacy commissioner, said he believes the legislation is working well and sees no need to change it.
"We remain at this point fairly convinced that having a discretionary section...(that) defaults to protecting privacy is the right way to go," Anderson said.
Ontario is behind other jurisdictions in battling the misuse of opioids, Gerace said. But if all the report's recommendations are implemented it would put the province way ahead, he said.
"I think we all know that we're in the midst of an opioid public health crisis," Gerace said.
"We know that on the street there are far more prescription opioids than there is heroin, that young people are using these substances more frequently and that there has been an increase in the number of deaths."
Ontario's deputy chief coroner, Dr. Bert Lauwers, said Ontario has seen an "alarming" rise in oxycodone deaths: 240 per cent from 2002 to 2006.
The report's authors stressed education as a key to tackling the problem. Due to the skyrocketing opioid abuse in Ontario there has been somewhat of a chilling effect among health professionals, said Dr. Stephen Wetmore.
"In the absence of clear guidelines some family doctors have over-prescribed opioids, some family doctors have under prescribed opioids and some family doctors are trying to avoid the issue entirely to the detriment of their patients who need treatment for chronic pain," said the report co-author and family medicine professor.
Pain management training for physicians in their undergraduate education is severely lacking, he said.
"Physicians receive less pain management training than virtually every other health-care provider including nurses, occupational therapists and veterinarians," Wetmore said.
Health Minister Deb Matthews recently announced plans to launch a new tracking system to monitor prescription narcotics and other controlled substances.
Matthews wasn't available Wednesday to comment on the report, but a spokesman said the ministry is reviewing the recommendations and how they fit in with current plans to curb prescription drug abuse.
"As part of a new narcotics strategy the province would track prescriptions through a new database that would flag unusual patterns of prescribing and dispensing," Ivan Langrish said in an email.
"In instances of inappropriate activity, responses could include educational support and resources, reporting to the appropriate regulatory college and in extreme circumstances, law enforcement."
