Glossary - Opioid Process Improvements

Opioids: A family of drugs that are usually prescribed to relieve pain. Examples include codeine (Tylenol No. 2, 3, 4), oxycodone, morphine, hydromorphone, and fentanyl.

Benzodiazepine: A family of drugs that are usually prescribed for anxiety, sleep or seizure disorders. Examples include Valium® (diazepam), Xanax® (alprazolam), and Ativan® (lorazepam).

OME (oral morphine equivalent) or MME (milligram morphine equivalent): OME or MME is a way to compare the analgesic (or pain relief) strength of different opioid medications. Often it is calculated for a 24 hour period. It is determined by using an equivalency factor to calculate the dose of morphine that is approximately equivalent to the ordered opioid. For example, 100mg OME equals: 20mg hydromorphone, 65mg oxycodone, 25mcg/hr fentanyl.

OUD (Opioid Use Disorder): Clinical diagnosis characterized by a pattern of problematic opioid use, linked to clinically significant impairment in function, and may include any of the following: cravings to use opioids, continued use despite experiencing social or interpersonal problems, tolerance, withdrawal, and others.

OAT (Opioid Agonist Therapy): An effective treatment for opioid dependency. The treatment involves taking opioid agonist medications (e.g. methadone or Suboxone®) to prevent the withdrawal symptoms, reduce cravings and support stabilization.

Suboxone®/Methadone: Medications that can be used for the treatment of opioid use disorder (OUD).

Suboxone® is the brand name for a combination medication that includes buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that prevents withdrawal symptoms without causing the person to feel high (euphoric). Patients must be in mild-moderate withdrawal in order to start Suboxone®.

Methadone is a long-acting opioid and therefore does not have the instantaneous mood altering effects of other short- acting opioids. Prescribers require additional training in order to prescribe and maintain methadone. Patients do not have to be in withdrawal in order to start methadone.

Virtual Opioid Dependency Program (VODP): An evolution of RODP, Opioid Addiction Treatment for Rural and Suburban Alberta Communities, which now offers same-day, province-wide OAT medication starts 7 days-a-week.

Harm Reduction: Set of practical strategies aimed at reducing negative consequences associated with drug use (e.g. safe injection sites, needle recovery programs, OAT, Naloxone kits). The defining features are the focus on the prevention of harm, rather than on the prevention of drug use itself and the focus on people who continue to use drugs.

Naloxone Kits:
A Naloxone Kit is also known as an Overdose Response Kit, or Take Home Naloxone Kit. Naloxone is an opioid antagonist which means it binds to the opioid receptor but doesn’t cause an effect. The kits are small, portable and can be used to respond and reverse opioid poisoning or overdose. Each kit contains:

• 3 vials of naloxone
• 3 safety syringes
• 3 alcohol swabs
• 1 pair of rubber gloves
• 1 barrier mask (for rescue breathing)
• An information pamphlet explaining how to inject naloxone

Dependence vs. Addiction: Dependence is characterized by the symptoms of tolerance and withdrawal, whereas addiction is marked by a change in behaviour caused by the biochemical changes in the brain after continued substance use. Different parts of the brain are responsible for each, thus it is possible to be dependent without being addicted.

Change Package: A quality improvement framework that consists of high-impact changes that are expected to occur when the potentially better practices are implemented. Key tools and resources are often linked to support the potentially better practices and suggested measures will track progress made towards the high-impact changes.