Calling Canada's opioid problem "nothing short of a public-health crisis," federal Health Minister Jane Philpott said on Friday that she has ordered Health Canada to do an expedited review of naloxone nasal spray, which can be used as an antidote to opioid overdoses.
Dr. Philpott announced that the government is also prepared to allow provinces and territories to import bulk shipments of the nasal spray from the United States until Health Canada's review is complete.
"We are in a crisis," she said. "But in this crisis, we will not merely be spectators."
The proposed changes mean that Canadians could have access to a user-friendly version of the life-saving drug before the end of the year. Currently, naloxone is available as an injection to reverse the effects of opioids. Earlier this year, the government loosened access to naloxone to make it available without prescription.
Canada is the world's second-largest per capita consumer of opioids. A recent investigation by The Globe and Mail detailed how policy failures exacerbated the crisis in Canada, leading to high prescribing rates, unnecessary deaths and soaring rates of addiction to opioids, as well as helped to fuel a rise in the rates of illicit fentanyl.
"These overdose deaths can certainly be prevented. Overdoses can also be treated," Dr. Philpott said in an interview. "These are people who are dying who wouldn't need to die if there were mechanisms for them to be able to access products like naloxone more easily."
The minister, who made the announcement about naxolone at a major drug policy conference in Toronto, indicated that a priority going forward is reducing prescribing rates of opioid painkillers as a way of battling high addiction rates.
She said in the interview that she "would not deny that there is reason for some concern" about the influence of companies that produce opioids. There are some areas the government may need to address, notably "where the pharmaceutical industry intersects with the medical community," she said.
At the drug policy conference, Dr. Philpott said she will also introduce changes requiring a prescription for low-dose codeine products, which are available over the counter, although they can lead to opioid dependence.
In addition, she said she wants to make risk-management plans for certain opioids mandatory, which means that doctors would need to complete an education course before being able to prescribe them.
Dr. Philpott indicated that numerous measures are being considered to address the opioid crisis.
She said she has asked Health Canada officials to reconsider whether the requirement for doctors to have a special exemption to prescribe methadone, which is used to treat opioid addiction, "still makes sense."
The government is working with provinces to develop monitoring systems that accurately capture all prescriptions issued by doctors, Dr. Philpott said. In the meantime, Health Canada inspectors can get reports directly from pharmacies and share them with provinces to help them spot potential abuse.
Dr. Philpott also said she will host an opioids summit this fall to look at addressing the epidemic of drug misuse and abuse.
In her remarks, which focused on the heavy toll that prescription opioids are exacting on the Canadian population, she outlined a road map to addressing the crisis that includes better warnings on drug labels, a rethinking of opioids as a front-line treatment for pain, improved monitoring of inappropriate prescriptions and more treatment options for people struggling with addiction.
In addition, Dr. Philpott underscored her support for harm reduction and indicated the government is potentially open to legislative changes that would make access to supervised injection and consumption sites easier.
Several drug-policy experts said Dr. Philpott's attendance at the drug policy conference and her comments demonstrate a commitment to tackling a complex public-health issue.
"She's really looking at a more diverse range of responses to both the pain management side of it, but also to begin to reduce the availability of opioids," said Donald MacPherson, director of the Canadian Drug Policy Coalition.
However, there are some concerns that clamping down too much could push those addicted to prescription opioids to illegal drugs, which would exacerbate harm.
"We need to set aside the knee-jerk approach that is embedded in drug prohibition," said Richard Elliott, executive director of the Canadian HIV/AIDS Legal Network.