Prescription drug misuse by doctors and their clients being probed by the Ontario government
As the Chiefs of the First Nations across the Sioux Lookout Health Zone meet to discuss the challenges facing their communities this week in Thunder Bay, the Ontario government announces a probe into the misuse of OxyContin.
Ontario to probe abuse of painkiller OxyContin
February 09, 2009 - Kevin Donovan, STAFF REPORTER
Ontario will lead a national probe into the misuse of the painkiller OxyContin, a prescription narcotic frequently doled out by doctors that can lead to severe addiction and death.
"We need a strategy to tackle this problem," said Helen Stevenson, Ontario's assistant deputy health minister in charge of drug programs. "We need a solution that really helps people and we need it quickly."
The decision to launch the probe came at a meeting of provincial and territorial health officials last Tuesday and was prompted by a Toronto Star investigation published the previous weekend.
The Star reported it found OxyContin prescriptions paid for by Ontario's public drug plan had tripled in five years, making it one of the most popular drugs. Last year, $54 million worth of the drug was prescribed, the majority to people on social assistance.
The drug is also prescribed and paid for through private drug programs and prescriptions in that market are also on the rise, though not as dramatically.
Meanwhile, the Star also found that addiction rates are soaring in the province and an estimated 464 deaths in five years have been blamed on oxycodone, the drug contained in the popular painkillers. That number is steadily increasing each year.
Both revelations, obtained by analyzing health ministry data obtained by the Star, seemed to take the provincial health ministry by surprise. The Star raised the issues with the ministry through a series of questions, but no action was taken until the story was published.
Stevenson said she sees "multiple problems" the review she is leading must address. Among them, finding out if the thousands of people prescribed the drug really need it.
Critics of the drug say OxyContin, a slow-release form of oxycodone intended for people in extreme pain, is given out by doctors too freely. A related problem is the issue of double doctoring, people who visit multiple doctors complaining of pain symptoms to obtain the drug for resale on the street. Known as "hillbilly heroin" by abusers, a $4 OxyContin pill has a street value of up to $45. Though intended for slow release over 12 hours, people addicted to the drug crush the tablets and either snort them or inject a liquid solution of the drug into their veins for an instant, heroin-like high.
Stevenson said she would like input into the review from Purdue Pharma, the maker of OxyContin.
A spokesperson for Purdue told the Star the company does its best to inform the public about the risk of addiction by educating doctors. In Canada, however, several lawsuits have been filed by patients saying they were not properly warned of the risks of addiction.
|In the United States in 2007, Purdue and three senior executives pleaded guilty to downplaying the risks of addiction and paid a court-approved settlement of $635 million, agreeing to provide better warnings of the drug's addictive nature. That settlement had no effect on how the Canadian product is marketed. Purdue spokesperson Randy Steffan said all federal guidelines are followed.
The new national review will look at the U.S. experience and also look at how other Canadian provinces have dealt with it. The Star found that in Ontario, there's no way for a doctor to find out if his patient has recently been prescribed OxyContin or another opioid-based painkiller. In British Columbia, doctors can check a patient's previous prescriptions online.
"Doctors can get real-time access to the database," said Dr. Heidi Oetter, registrar of the British Columbia College of Physicians and Surgeons. They also have special banknote quality prescription forms that doctors must use if they are going to prescribe a narcotic. Oetter said the system helps reduce abuse. In Ontario, there are no special prescription forms for narcotic drugs.
An Ontario health ministry spokesperson said Ontario is working on a plan for a computer-based system that will provide an "electronic health record" by 2015. That system would allow doctors to check the prescription history of a patient.
But Stevenson said her review aims to solve at least some of the problems this year. "This is a very immediate problem."