Health Canada is moving to further restrict the way opioids can be promoted, years after experts first sounded the alarm about opioid advertising claims.
A proposal the department announced on Monday would allow opioid manufacturers’ ads to use only the language in the product monograph, which is a technical document that describes how a drug should be used. Companies will have to include information on the benefits and the risks of opioid medications, according to the proposed changes, which could take effect as early as June. The restrictions apply to advertisements that go to health-care professionals. Health Canada does not allow opioid manufacturers to advertise to the public.
Under the current system, companies selling opioids and other prescription drugs are free to choose the wording, as long as it is not false or misleading and is in keeping with the drug’s approved use. But opioid manufacturers have long been criticized for minimizing the risks of their drugs in ads that suggest they work well for chronic pain. Last year, a group of academics wrote to the federal government to call for a criminal investigation of the marketing tactics of opioid manufacturers, which they said led to overprescribing and the current crisis.
David Juurlink, who has studied the problems of opioids for years and was a signatory on last year’s letter, says the new measures would bring no meaningful change.
“This horse left the barn in the late 1990s,” said Dr. Juurlink, head of the division of clinical pharmacology and toxicology at Toronto’s Sunnybrook Health Sciences Centre. “We needed constraints on opioid marketing two decades ago. In 2019, they won’t do anything to address the crisis that we face.”
Dr. Juurlink said the government needs to focus on measures that will help reduce the number of people dying of drug overdoses and get them treatment to reduce their dependency on opioids.
About 11 people die every day in Canada as a result of opioids. Most of those deaths are linked to illicit forms of fentanyl, which is a powerful opioid, added to street drugs. People often are not aware they are using fentanyl.
Rhonda Kropp, director-general of the marketed health products division at Health Canada, said the advertising restrictions would not solve the opioid crisis, but are one of many actions the government is taking to address the situation.
But Dr. Juurlink said the federal government needs to take much bolder actions than it has so far to reverse the course of the public health crisis. He echoed calls from other addiction experts for Ottawa to increase the number of sites where people can use drugs in the presence of trained workers who can, among other things, help someone who is overdosing. Dr. Juurlink also questioned why Health Canada continues to approve new opioids for the treatment of chronic pain, given that mounting evidence shows they are not a very effective long-term therapy and come with high risks of dependence and addiction. And he suggested the government take high-dose formulations of opioids off the market, as the risks are simply too high.
“The easy things get done while the hard things seem to mainly get talked about,” Dr. Juurlink said. “It’s the hard things that are going to make a difference.”