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Accountability - Responsibility...You Decide??

Should doctors be responsible for opiate and narcotic addiction?I read an article written in Business Week online regarding the nation’s Vicodin epidemic in the United States.  I began to question the issue of accountability within our Canadian health care system.

Working as a nurse and counsellor in Substance Abuse and Addiction, as well as previous work experiences in Corrections and currently working in a drug rehabilitation centre, I have become very aware of just how easy it is for people to get prescriptions for many types of opiate and/or narcotic based pain killers. Oxycontin has become Canada’s nation-wide epidemic. 

Here is an example I have created on how easy it is to obtain these medications. Jane Doe has been addicted to cocaine for a couple of years; at a party she is given an 80 mg. tablet of Oxycontin. She liked the feeling of euphoria she got from this one little pill.

Jane learns from others at the party, that if she created a physical problem with serious pain issues, she could get her own prescriptions for Oxycontin. Two days later she sees her doctor and tells him that she has been having severe back pain. It has become so bad that she cannot sleep through the night without pain waking her up. Her doctor has her do a few bends and twists from the waist, she grimaces in pain. Within 15 minutes Jane Doe walks out of the office with a prescription for Oxycontin.

The first month Jane follows the doctor’s instructions taking the Oxycontin as prescribed and returns to him saying that it really helped, without hesitation the doctor gives her another prescription. With this bottle of pills, Jane begins taking more than prescribed and with the addition of her cocaine addiction she is now addicted to Oxycontin.

The story goes on with Jane Doe working the system by jumping from doctor to doctor and pharmacy to pharmacy. It takes over a year before the College of Physicians and Surgeons catches on to what is going on and notifies the doctors and pharmacies not to prescribe or fill prescriptions for this medication for Jane.

We now have an addict that heads to the streets to buy her Oxycontin to feed her habit. How does this happen? It would have been better if the first doctor took the time to order a variety of tests to determine the severity of Jane’s back pain.  Organising an x-ray at the very least or an MRI, before determining what course of action to take before prescribing such a medication. 

Some may say that doctors are not responsible when a patient tells them they have pain. The issue of pain justifies the prescription. My thoughts are that it is known across Canada that there is a serious issue with people suffering addiction to Oxycontin.  There are people with legitimate pain issues that become addicts because of these types of prescriptions. Why are we, as country not questioning the accountability and responsibility of our doctors?

This is not a new problem in the country. OxyContin was introduced to Canada’s market in 2000, three years later it has been recorded that 2.8 million prescriptions were written alone for this opiate painkiller. Almost 9 years later, the rate of OxyContin addiction has risen from 4% to 55%.  We live in a country where medical detox is covered with a high cost to its tax payers in the millions upon millions of dollars through the government’s withdrawal management programmes.

I put to you this question, if the doctors today were accountable for the addiction created by Oxycontin prescriptions, would they become more responsible in how they prescribe this drug?

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National Association of Addiction Treatment Providers International Security for Traumatic Stress Studies The Canadian Positive Psychology Association The Association for Addiction Professionals