Friday, November 20, 2009 – Globe and Mail
ANNA MEHLER PAPERNY
In the face of Canada’s growing pill problem, Ontario is moving to change the way opioids are prescribed and monitored.
New regulations to be put in place in the coming months would crack down on prescription abuse and set new benchmarks for how these pills should be doled out in an attempt to deal with the growing numbers of people getting hooked on painkillers across the country.
Addiction experts say the changes are badly needed and should have come a decade ago.
The province’s health ministry hopes to have an electronic database of prescription drugs set up as early as April, 2010. It is something provinces such as B.C. and Alberta have been doing for decades.
The moves also includes educating doctors and limiting the number of pills they should prescribe.
“It’s been a long time coming. We need to have some kinds of checks and balances on how these medications are prescribed,” said Peter Selby, director of addiction programs at the Centre for Addictions and Mental Health in Toronto.
“[But] we need a more comprehensive strategy around better management of pain, better understanding of how addiction develops.”
Canadians pop more prescription painkillers per capita than people in almost any country in the world, behind only Belgium and the United States.
A 2006 study found prescription opioids topped heroin abuse in every Canadian city but Vancouver and Montreal.
“It’s become apparent that there’s a prescription drug problem in the province, and the ministry is making a serious attempt at, firstly, identifying its scope and … ultimately, offering solutions,” said Doug Gourlay, a specialist in addiction and pain who sits on the Narcotics Advisory Panel that is behind the proposals.
But “it’s hard to imagine that simply quote-unquote ‘clamping down’ on prescribing will solve the problem.”
A database of who is being given what is intended to prevent people from getting prescriptions from different doctors.
“They should have done it 10 years ago,” said Clement Sun, who runs a methadone clinic in downtown Toronto.
Dr. Gourlay said he hopes the province will focus on educating doctors in pain management and making more treatment resources available – including buprenorphine, an alternative to methadone that is often better for prescription-drug addicts but isn’t paid for by the province.
Meantime, 100 pages of draft guidelines meant to help doctors prescribe painkillers and watch for addictions is in the final stages of review.
Robbert Vroom, registrar of British Columbia’s College of Physicians and Surgeons, said he plans to hold that province’s doctors to that standard.
“We have a serious problem in the province with abuse of oxycontin,” Ontario Health Minister Deb Matthews told reporters yesterday.
“For me, it is a very high priority that we move forward on it,” she said. “I feel a real degree of urgency on this.”
With a report from Karen
Total amount Canadians spent on prescription opioids in 2007.
Prescription opioid doses per million people in Canada – the third-highest in the world.
Percentage of people in the Centre for Addiction and Mental Health’s opioid withdrawal program for oxycodone in 2000.
Percentage of people in CAMH’s opioid withdrawal program for oxycodone in 2004.
Percentage of prescription-drug abusers aged 18 to 25 who got their pills from one or several doctors.