Prescription opioid misuse and dependence has become an increasing problem and is linked to an array of negative consequences including addiction, overdose, and mortality. Although most chronic opioids are prescribed in the community, use in hospital and on discharge significantly increases the risk of chronic use and is often the first point of use for previously opioid naïve patients. While the use of high dose opioids in hospital can increase the risk of adverse events and length of stay, untreated pain continues to remain an issue for many patients, and finding the balance of managing pain while using opioids as safely as possible remains an ongoing struggle.

The Opioid Stewardship Program at St. Paul’s Hospital is a systems-level intervention developed to address this ongoing gap in care. Implemented in January 2020, the opioid stewardship clinical team consists of a clinical pharmacy specialist and addiction medicine physician who review and assess patients throughout the hospital and provide recommendations to improve the use of opioids. The program also addresses system wide prescribing through education and review of hospital policies and order sets.

Coming Soon


The objectives of the AESOP study are:

  1. To evaluate the impact of an Opioid Stewardship Program on rates of inappropriate opioid prescribing, and short-term hospital and health-related outcomes
  2. To evaluate the uptake and acceptance rate of the Opioid Stewardship Program services and recommendations
  3. To evaluate the independent effect of the Opioid Stewardship Program on costs borne by the healthcare system
  4. To develop and incorporate integrated knowledge translation activities that will ensure lessons learned are shared with other settings


The Opioid Stewardship Program and AESOP study are a partnership between the BCCSU and Providence Health Care.

As part of the Opioid Stewardship Program, an Opioid Stewardship Advisory Committee was also established and includes representation from pharmacy, nursing, addictions medicine, acute pain service, complex pain service, general surgery, orthopedic surgery, internal medicine, obstetrics and gynaecology, and a patient and family representative.


This work is made possible through funding from the Vancouver Foundation.


To learn more about the Opioid Stewardship Program, please contact us:

Tamara Mihic
Clinical Pharmacy Specialist – Opioid Stewardship
Email: [email protected]

BC Centre on Substance Use

400-1045 Howe St, Vancouver, BC V6Z 2A9

E: [email protected] | T: (778) 945-7616 | F: (604) 428-5183

24/7 Addiction Clinician Support Line: (778) 945-7619

Online Addiction Medicine Diploma: [email protected].

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