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Ontario considers changing who can prescribe opioids, and how

Canada's largest veterans facility already has sufficient government oversight, so there's no need to impose further accountability measures, Ontario's Health Minister Deb Matthews says. (Aaron Lynett / National Post)

Ontario Health Minister Deb Matthews wants to re-examine who’s allowed to prescribe opioids, how they prescribe them and what pills the government pays for.

The drop in OxyContin and its replacement OxyNEO is “a success,” she told Global News in an interview Tuesday. But “there’s more to be done. … Who should be able to prescribe these drugs? What form is the right form? These are very important questions.”

And while she says the surge in prescriptions for other, more powerful opioids doesn’t entirely come as a surprise, she won’t commit to putting the same constraints on them that now apply to OxyNEO. This could include requiring doctors to make a special application, approved by someone working in the ministry, before issuing a prescription.

“We knew that when the old formulation of OxyContin came off the market that people with addictions would look for other drugs. … So it does open up that whole question,” she said. “Some of these very powerful drugs are truly lifesavers for people who actually need them. The concern is for people … who don’t.”

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Ontario is Canada’s epicentre of prescription-opioid abuse; overdose deaths have more than tripled in a decade. And Matthews has made tackling prescription opioid abuse a personal priority – rooted, she says, in stories from people she met in her London riding well before she became health minister.

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And while Ontario has been more aggressive than most provinces in the past couple of years, it’s still well behind British Columbia and Nova Scotia in its prescription monitoring program: Doctors, for example, can’t immediately look up a patient’s prescription history when someone walks in complaining of back pain.

Tightening the rules around who can prescribe these drugs – by requiring them to get a licence, for example – might not go over well with many people in the medical and pain-treatment communities: Some say putting that barrier in place might scare physicians away from prescribing altogether.

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Matthews said she’s waiting on recommendations from a group of experts. She would give no timeline on a decision. “But, I can tell you, the sooner, the better.”

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Read: The view from the world’s potent-opioid capital

Read: OxyContin’s gone, but Canada’s pill-popping problem is worse than ever

Read: One company, two drugs, two takes on pill safety

Read: The importance of earnest health-data collection

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