Deb Matthews has seen the stats that show her province has the worst rate of prescription-drug addiction in the country. And she’s heard the stories: northern cities fighting a losing battle, native communities torn apart, small towns contending with thefts and break-and-enters so residents can feed their habits.
But Ontario’s Health Minister doesn’t need to go far afield to find motivation for the policy response she’s set to begin rolling out in the coming weeks. She just has to wander a few blocks from her constituency office.
The east side of London, Ont., has it bad. Along the main drag of Dundas Street, there are drug houses, rehab centres, a disconcerting number of young women working the street, and an equally disconcerting number of young men wandering aimlessly.
A variety of poisons like crack and crystal meth are shared among them. But OxyContin is king.
Listening to experts rhyme off the horror stories – Families broken apart! Hundreds of overdose deaths! Teenagers holding “pill parties!” – it can sound like the latest in a long line of drug scares. Some social workers are quick to dismiss it as such, suggesting the root causes don’t change much with whatever narcotic is in fashion. And indeed, many people are down and out before they start self-medicating.
But there’s something more going on here. Through over-prescribing, the public-health system is actively, if inadvertently, creating thousands upon thousands of drug addicts. And it’s flooding the streets with the pills to feed those addictions.
Laura wasn’t yet 20, working as a landscaper, when she had surgery for carpal tunnel in her hand. The doctor prescribed her Oxy.
Back then, she just popped the pills. Today, like most addicts, she injects for a quicker and more direct fix not unlike heroin.
“I was somebody,” she says, now 27 years old and working in London as a prostitute. It doesn’t come out ruefully – more like she knows she’s reciting a cliché.
Laura (not her real name) smokes crack sometimes; it’s her boyfriend’s drug of choice. But like an estimated 70 per cent of local street prostitutes, she mostly uses a drug dispensed at pharmacies. And even as she talks about the horrible crashes, the judgment from passersby, her anger at the doctor she sees as responsible for inadvertently hooking her, the abuse she’s taken from johns – she knows she’s a long way from escaping what began nearly a decade ago.
“I fucking love Oxy,” Laura says.
No easy solution
A lot of Ontarians feel the same way Laura does – and it’s only recently that the government recognized it’s a problem.
In fairness, everyone was caught off guard by the explosion of OxyContin – a slow-release form of the opioid oxycodone – after it hit the market in the 1990s. But some provinces have been quicker than others to recognize that the highly addictive chronic-pain reliever is widely abused, and moved to monitor and restrict the amounts prescribed and dispensed.
“Ontario is doing worse on this front than any other province, by a long shot,” Ms. Matthews says during an interview in her riding. The numbers speak for themselves: In 2008, OxyContin was sold by Ontario pharmacies at more than double the national average.
In 2008-09, it accounted for 45 per cent of the staggering 3.6 million opioid prescriptions paid for by the Ontario Drug Benefit – the public plan that covers seniors and low-income patients. (By 2009-10, the ODB was up to 3.9 million opioid claims, made by 776,000 people.) It’s not known how many more prescriptions are sold to cash-paying customers or private plans.
Ms. Matthews, who first took an interest in the file during her previous posting as minister of women’s affairs and children’s services, knows that at this stage there’s no easy solution.
