This crisis of prescription drug addiction in Canada won't go away on its own. It costs society millions of dollars a year in lost productivity, health care, law enforcement and related social costs. Addicts, many of them aboriginals, lead lives of terrible suffering.
The decision by several provinces, including Ontario, to place new restrictions on OxyContin, and the drug replacing it, is a good first step toward addressing the epidemic. But it is not enough. More treatment programs are needed, especially for those living in remote communities. More doctors could be trained to prescribe methadone or suboxone, two drugs that control withdrawal symptoms and help addicts maintain sobriety.
De-listing the popular painkiller in Ontario won't cause an epidemic of withdrawal, as some argue, because its new, harder-to-abuse version, OxyNEO, will still be funded through the province's Exceptional Access Program. Since prescriptions will fall under stricter regulations, legitimate users of the drug will still have access.
While some addicts may turn to other painkillers or illicit drugs, others may be motivated to seek treatment. "We can't just sit by and let the current epidemic continue," says Dr. Mike Lester, a physician who works at a methadone clinic in Toronto. "At the same time, there are no easy answers. Almost everyone we treat for addiction has many other problems."
Doctors who prescribe opioids need better training to monitor patients whom they suspect are selling the pills on the black market. Better controls on how opioids are prescribed could also diminish the practice of doctor-hopping, by which patients get multiple prescriptions for the same ailment.
When OxyContin was first introduced into Canada in the mid-1990s, it led to a huge increase in the number of doctors willing to prescribe the drug for a wide range of pain complaints, filling an important void in chronic-pain management.
However, it soon became apparent that the long-lasting pain reliever was very addictive. OxyContin releases as much as 80 milligrams of the narcotic known as oxycodone in the course of 12 hours. Addicts who crush, chew or inject the pills get an intense, instant high. OxyNEO is harder to abuse because it cannot be crushed, chewed or injected.
Canada has the second-highest rate of opioid consumption in the world, after the United States. The annual number of deaths related to opioids is more than double that from HIV infection. This is a public-health emergency that cannot be ignored. Restricting access to OxyContin and OxyNEO is sound public policy, as long as it is accompanied by a host of other measures to help addicts.