The number of opioid prescriptions filled in Ontario grew significantly over three years, affecting almost one in seven people, despite an increasing overdose “crisis” from drugs such as fentanyl that has swept across Canada.
A new report from Health Quality Ontario released Wednesday found that almost two million Ontarians — close to 14 per cent of the population – filled prescriptions for the highly addictive and potent medications in the 2015/16 fiscal year.
“More people are getting opioids, more people who are taking opioids and getting more prescriptions and the potency is increasing,” Dr. Joshua Tepper, CEO of Health Quality Ontario, told Global News.
“There are simply more opioids being prescribed than ever before.”
WATCH: Alan Carter has more on Ontario opioid prescriptions.
About 44,000 health care professionals prescribed opioids over a one-year period in Ontario, and the study found the most common drugs include oxycodone, hydromorphone, codeine, morphine and fentanyl.
“It’s fair to say that when 14 per cent of a province’s population is receiving an opioid, we have a problem,” Dr. David Juurlink, a drug safety researcher at Sunnybrook Hospital in Toronto, said.
“We have a problem with pain, but we also have a problem with how we’re treating it.”
In the last three years, the total number of prescriptions filled by Ontarians increased from 8.7 million in 2013/14 to nearly 9.2 million in 2015/16, according to the report.
That’s an increase of almost 450,000 prescriptions over the same period three years earlier, despite the unfolding national opioid epidemic and growing awareness in the medical community about their potential for abuse.
“I think the numbers are staggering,” Tepper said. “To see this increase during this same time period is pretty concerning.”
VIDEO: Politicians, experts react to new report on rising opioid crisis in Canada
Tepper said that while the number of prescriptions for patients who take opioids is rising, so too is the prevalence of more potent types.
The report showed the prescribing of powerful opioids had grown, 29 per cent more patients received hydromorphone in 2015-16 than in 2013-14, while less potent types such as codeine had decreased.
That’s something Tepper called “surprising” given the current efforts in the political and medical communities to curb the growing problem.
Earlier this month, new national opioid prescribing guidelines for physicians were published in the Canadian Medical Association Journal in an effort to address this issue.
Doctors were encouraged to avoid giving the powerful narcotics as a first-line treatment to patients with chronic, non-cancer pain and instead try other medications or non-pharmaceutical therapies to prevent a host of potential harms associated with the widely used drugs.
Ontario Health Minister Dr. Eric Hoskins said in a statement Wednesday the report would help “strengthen” the provincial government’s response to the opioid crisis.
“We all have a role to play in preventing people from becoming dependent on opioids as well as supporting those who are affected by opioid use disorder,” he said. “In Ontario, we have been clear about the need to urgently address the opioid crisis.”
Hoskins announced an opioid strategy for the province in October to help address what he called a “public health crisis” of addiction and overdoses.
The new measures included expanded access to substance abuse treatments, supervised injection sites and the overdose antidote drug Naloxone, de-listing highly potent opioids and an additional $17 million a year on 18 chronic pain clinics.
Federal Health Minister Jane Philpott said Tuesday that over-prescribing by physicians is one of the “real drivers of the overdose epidemic.”
“In the last 20 years, prescribing patterns for opioids in North America have skyrocketed,” she told reporters at an event in Ottawa.
“We know that in fact they have high addictive potential, so this has led to Canada having the second highest use of opioid prescriptions in the world – second only to the U.S. … and that has led to this terrible crisis of skyrocketing numbers of people who are dying of overdoses related to opioids.”
Families hit hardest
Donna May knows the realities of opioid addiction firsthand.
In 1995, May was prescribed an opioid for chronic pain from a degenerative disc disease and quickly found herself becoming addicted.
“I took opiates for about a month and a half and the side effects were debilitating themselves … and the withdrawal was horrendous,” she said, adding she forced herself off the drugs “cold turkey.”
“Fortunately I was one of the ones who didn’t overdose.”
But May then watched her daughter Jac fall into an OxyContin addiction years later after being prescribed the medication following a bad fall down a set of stairs, but when her physician cut her off she turned to the black market.
“She was just left on her own, and she was already very heavily addicted to the drug,” May said, adding she had stolen medication from relatives to feed her addiction leading her doctors to abruptly end her prescription.
“They cut her off and she went to the street and then just sought out more and more higher strength opiates and ended up having fentanyl as her drug of choice.”
Jac died of an opioid overdose in 2012. May believes that first OxyContin prescription ultimately led to her death.
“I absolutely think that if she hadn’t been prescribed Oxy in the first place, that she would still be here to speak to us today,” May said, adding that she’s not surprised prescription levels have risen.
“I believe that the education that was needed should’ve come down to the doctors to begin with.”
May said that when patients are taken off medications, there needs to be greater care taken to prevent them from turning to the street.
“And today that is very, very dangerous,” she said. “The quality, the quantity of drugs that are out there on the market on the street today — we can’t be sure that they’re going to be safe.”
VIDEO: Donna May speaks out about losing her daughter to opioid addiction
May now runs an organization called Moms United and Mandated to Saving the Lives of Drug Users to support families who struggle with the same issues related to addiction.
“I encounter moms and dads and siblings every single day who call me up to say, “Hey, it’s happened to me too. My child is either overdosed and is either permanently impaired or has died to an opiate overdose,” she said.
“I would say that the opiates are the leading cause of addiction … And what it’s led to is a crisis of overdose.”
With files from Veronica Tang and The Canadian Press