McMaster University

Michael G. DeGroote
National Pain Centre

Scope of Search

Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain


Canadian physicians and medical regulators recognized a growing need for guidance regarding opioid use for chronic non-cancer pain. In late 2007, under the umbrella of the Federation of Medical Regulatory Authorities of Canada, provincial and territorial medical regulatory authorities formed the collaborative National Opioid Use Guideline Group (NOUGG) to oversee development of a clinical practice guideline:  the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-cancer Pain.

A research group conducted a systematic review to identify evidence from the literature regarding use of opioids for chronic non-cancer pain. The researchers drafted initial recommendations for practice that underwent structured review by a multidisciplinary National Advisory Panel that included 49 individuals from across Canada providing medical expertise in family medicine, pain and addiction, patient perspectives, and views of other healthcare providers. After four rounds of a structured review process, the National Advisory Panel achieved consensus on 24 recommendations for practice included in the Canadian Guideline.   

The practice recommendations in the Canadian Guideline will assist physicians to use opioids effectively and safely for chronic non-cancer pain.  This clinical practice guideline will also help patients to be informed about the potential benefits and risks of opioids, and enable other healthcare providers to be aware of roles they can play to achieve desired patient outcomes.

The goal of the National Opioid Use Guideline Group was to develop and implement into practice, advice for physicians to effectively manage patients with chronic non-cancer pain and to prescribe opioids in a safe and effective manner. Guideline development is complete and implementation activities are underway or planned for 2010 and 2011.