Canada’s next painkiller crackdown won’t come from Ontario.
Its removal of OxyNEO from the Ontario Drug Benefit successfully sidelined Purdue’s replacement for what was once the most notoriously addictive opioid – OxyContin.
And the province now collects data on all prescriptions filled, not just those the government pays for.
But tackling Canada’s fastest-growing addiction is turning into a game of whack-a-mole: Prescriptions for just about every other potent painkiller are up – way up – in the past two years. Fentanyl and Hydromorph Contin, two especially potent, addictive and easily abused drugs, have increased significantly: Prescriptions for Hydromorph Contin, which packs more punch, per milligram, than OxyContin, increased from 25,000 in February, 2012 to 48,000 in September, 2013.
Yet the province has no plans to tighten the rules on these skyrocketing prescriptions, even though data obtained by Global News shows they’re killing more people.
Prescription opioids overall are killing more Ontarians than ever before – more, annually, than drivers killed in car crashes and 346 per cent more in 2012 than a decade earlier (2012 numbers are still considered preliminary). And hydromorphone, the active ingredient in Hydromorph Contin, went from killing 24 people in 2008 to 64 people in 2012.
The province may now also be the best place in Canada to collect data on these drugs: In many regions it remains fearsomely tricky to get both prescriptions and causes of death broken down by type of opioid; provinces tend to track prescriptions differently (trust us, we’ve checked).
And the federal government has no plans to collect this data itself: That’s the provinces’ domain, a Health Canada spokesperson confirmed to Global News in an email this week.
Meanwhile, Ontario’s newly minted Health Minister Eric Hoskins is looking to Ottawa: Health Minister Rona Ambrose is exploring the possibility of making more drugs “tamper-resistant” – tougher to crush and snort or inject, which become a hardcore addict’s modes of choice because they provide a better high.
“It needs to be a national priority,” Hoskins said in a scrum following Question Period Tuesday.
An emailed statement from Ambrose’s office called requiring tamper-resistant drugs “one piece of the puzzle.
“Curbing prescription drug abuse is also about education – it’s about working with the prescribers around challenging issues like ‘doctor shopping’ and over prescribing,” the statement reads.
“We all have a role to play, and the Minister made it clear that she is committed to continue to work withaddiction experts, the medical community and law enforcement.”
But even if that standard applied to all potent painkillers, it’d be at best a moderate deterrent – “the idea that this is going to solve the problem is specious,” says Sunnybrook Health Sciences Centre’s David Juurlink.:It remains possible to crush the pills if you really want to, and they’d be just as addictive as before – that wouldn’t address the issue of over-prescription that appears to have transferred from one drug to equally powerful alternatives.
While Ontario’s “always looking to improve” its narcotics strategy, there’s no immediate plan to put other swiftly growing painkillers – fentanyl, for example, which according to preliminary coroner’s statistics killed about 116 people in 2012; or Hydromorph Contin, responsible for about 64 deaths – on its Exceptional Access Program, which makes doctors fill out a special form before prescribing the drug. This way it’s still there if you need it, but doctors must think twice before prescribing.
“It is important to recognize, as well, that there is a balance to be struck,” Hoskins said.
“There are many individuals in society that have a legitimate reason to be taking these drugs.”