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At a rate of more than 466,000 doses a day, Canadains pop more painkillers (like Oxycontin, shown here) per capita than almost any other country (topped only by the United States and Belgium). (Kevin Van Paassen/The Globe and Mail)
At a rate of more than 466,000 doses a day, Canadains pop more painkillers (like Oxycontin, shown here) per capita than almost any other country (topped only by the United States and Belgium). (Kevin Van Paassen/The Globe and Mail)

Canada's painkiller problem Add to ...

Janey Nagle wasn't looking for kicks when she began courting a drug habit. The Percocets her doctor prescribed were the only thing that could take away the excruciating pain that lingered a decade after a car accident threw her into a windshield with such force that her face left an imprint in the glass.

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For the first two years, the painkillers did the trick. The Perth, Ont., mother of four was able to work and look after her family. But after a while she couldn't get through the day without the pills' euphoric effect, and that demanded higher and higher doses.

Fearful her doctor would cut her off, Ms. Nagle looked elsewhere. She spent hundreds of dollars a day on prescription drugs bought off the street, primarily from friends and acquaintances. She photocopied her prescriptions and filled each one repeatedly at pharmacies around Perth, Kingston and Smiths Falls.

“It was a horrible, panicked feeling every morning when I woke up,” says Ms. Nagle, now 43. She remembers the daily dilemma: “How am I going to get them? Where am I going to get the money?”

This went on for years before she was caught at a drugstore and charged with forgery.

Like Ms. Nagle, Canada has fallen quietly into the grip of a pill problem in the past decade. Medications designed to treat pain and anxiety are creating legions of accidental addicts from coast to coast. In Regina, it's morphine; in Toronto, OxyContin and Percocet; in Edmonton, OxyContin, various benzodiazepines and the whole Tylenol gamut.

At a rate of more than 466,000 doses a day, Canadians pop more painkillers per capita than almost any other country (topped only by the United States and Belgium). Spending on prescription opioids more than doubled from 1998 to 2007, and prescription-opiate abuse grew an estimated 24.3 per cent from 2002 to 2005, according to a study published this year in the Canadian Journal of Public Health – while heroin consumption fell 6.5 per cent.

The federal government's national anti-drug strategy has spent tens of millions of dollars on prevention and enforcement initiatives, targeting the country's most hard-core heroin, methamphetamine and crack addicts.

But the fastest-growing group of addicts doesn't fit that mould: They're getting drugs from pharmaceutical shelves or buying pills on the street in transactions police have difficulty preventing because the drugs themselves are legal.

In 2000, less than 4 per cent of the opiate addicts in withdrawal treatment at Toronto's Centre for Addiction and Mental Health (CAMH) were addicted to oxycodone, the primary ingredient in such prescription drugs as OxyContin, Percocet and Percodan. By 2004, that figure had climbed to 55.4 per cent.

The problem is complicated by what CAMH doctor Curtis Handford calls an “epidemic of chronic pain” in a stressed and aging population, and doctors “whose options to treat that condition are limited. They have an inundation of marketing and guidelines telling them that opioids are a legitimate treatment choice.”

Under those conditions, he says, doctors can be too indiscriminate in their prescriptions and not careful enough about monitoring patients at risk of addiction.

Across Canada, this crisis is prompting medical authorities to study changing the way these drugs are controlled and policed. But some observers question whether these steps will be enough to get the prescription-drug monkey off the nation's back.

What begins with pain-suffering adults often gets picked up by thrill-seeking youth. A 2007 survey of Ontario students found that more than one in five had taken painkillers that weren't prescribed to them at least once in the past year. This could mean something as innocent as sneaking a pill from a friend's medicine cabinet, notes Jurgen Rehm, a senior scientist at CAMH. But it's indicative of how prevalent and acceptable prescription-drug abuse has become.

“We know that prescription-opioid abuse is the main mode of drug abuse among street kids and street drug users in general,” Dr. Rehm says. “We know from the U.S. that there's a parallel between the abuse and the availability of prescription opioids.” He adds: “We had been concentrating so much on heroin. … We always thought that [pills are]just the lesser evil.”

But that view is out of date. In preparation for a groundbreaking study on heroin treatment in 2004, doctors in Toronto ran into a bizarre problem – there weren't enough heroin addicts.

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