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Canada’s OxyContin Mess

OxyContin abuse costs Canada $504 million annually. Around 2000, OxyContin appeared on Canada’s market. Twelve years later, the province of Ontario has the highest prescription opioid-related deaths and opioid addicts than in any other province in Canada.  First Nation Reserves in Ontario especially in the north have declared states of emergency.  Today Ontario wants to prevent a second-wave prescription drug crisis.

Ontario cannot do this alone.  They need help from the federal government and this is an excellent opportunity for both federal and provincial government to collaborate to address a serious national health problem.

There are several ways that Health Canada can alleviate the effects of prescription drug abuse.  Preventing Canada from having a form of generic oxycodone in the market is one of them, an unusual step because generic drugs are usually considered a good thing.  But causing a stop in this case would reward the drug manufacturer that contributed to the overuse of OxyContin in the first place (Purdue Pharmacy produces a tamper-proof version called OxyNeo).

Deb Matthews, Ontario’s health minister, along with other provincial health ministers have asked Leona Aglukkaq, their federal counterpart, to restrict the generic version of OxyContin.  The generic form could come in Canada when the patent expires soon this month. Thus far, Aglukkaq has looked into this issue. The federal health department must do this and also take this opportunity to reveal how it can play a leadership role which will include more help for reserves that are under federal jurisdiction.

The case against generic oxycodone is strong and underlines the costs of provincial health as well as social and justice systems because of the drug. Not to mention the lives lost. The Canadian Medical Association published a study in 2009.  Deaths increased five times after OxyContin, the most popular version of the painkiller, when it was introduced to the public drug plan in the province of Ontario. From 2003 to 2008, prescriptions for the drug tripled there and the number of related deaths increased every year. Ontario delisted it earlier this year and Deb Matthews says she wants to prevent the generic from entering into her province as well.

“The devastation of this drug is unbelievable,” Matthews stated during an interview.

There is ample culpability going around the issue of opioid prescription abuse in Ontario and Canada. Ontario’s failing was their lack of a tracking system where it would have been able to monitor who was getting high amounts of the prescription so it could crack down on oxycodone abuse.  Today, pharmacists are able to track narcotic prescriptions.  Unfortunately doctors are not able to find out easily if a patient has been prescribed a narcotic by another physician. Other provinces are able to do a much better job tracking this. The OxyContin issue should emphasise the importance of an electronic database to monitor and be aware of prescription drug use and abuse in the province. The cost of not building such a system outweighs the cost of creating one.

Physicians should start to take responsibility for the dependence on narcotic painkillers in recent years. In the United States alone, prescriptions for painkillers nearly tripled in 20 years. Ontario and the rest of Canada are not lagging far behind.

In the US, Purdue Pharma has paid hefty fines for misleading the public about the addictiveness of OxyContin. Its new time-release formula, OxyNeo, was thought to be the answer to the abuse and addiction problems associated with OxyContin.  But it was tampered with easily because many of the addicts were able to find a way to grind and inject it for a quick high.

Is there any case for approving generic OxyContin in Canada? A Canadian Health Policy Institute Report warns that the social costs of approving the generic could far outweigh any savings to governments. In 2011, the institute estimated that $504 million is the annual cost from OxyContin abuse. Of that amount, $318 million represents Ontario’s costs alone.

A physician and scientist at Toronto’s St. Michael’s Hospital, Dr. Irfan Dhalla studied OxyContin.  He says there is no role for a generic OxyContin in Canada.  There is a newer version, OxyNeo, which is difficult to tamper with and causes fewer problems. He states that prescription opioids cause up to 1,000 deaths in Ontario yearly.

Prescription drug abuse has also crippled a number of our First Nations Reserves, but its effects have been experienced all over Canada. Cleaning up this OxyContin mess should be the job of both provincial and federal governments.

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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