THUNDER BAY – An estimated 10,000 to 20,000 Canadians acquire died from opioids since 1995, and every untold number now suffer from surrender.
Dear Minister Jane Philpott,
Congratulations in c~tinuance your appointment as minister of Health. As ~y experienced physician, you bring valuable prospect to the post. While there are various contentious matters before you, including a unused health accord, physician-assisted dying and marijuana legalization, scarcely any could be more pressing than the prescript opioid epidemic. It is an issue completely but ignored by your predecessors unless it is the greatest drug close custody crisis Canada has ever faced.
When you returned to Canada in 1998 following nearly a decade of practice in Africa, you witnessed the seeds of this prevalent being sown, with strong painkillers like OxyContin prescribed liberally concerning chronic back pain, arthritis and fibromyalgia. You heard experts ~ing these drugs worked well for of long duration pain, that the risk of addiction was low, and that doctors who resisted prescribing them were “opiophobic.” Perhaps you unruffled began prescribing opioids for chronic chagrin, as did I and thousands of our colleagues, heedless that what we had been told was contrary to fact.
It’s clear now that we were objects in one elaborate marketing effort. Cloaked as it was in the virtues of kindliness and beneficence, it was a peculiar success – until, that is, we considered our patients. Today, doctors’ offices are inundated with people who have been harmed greater degree of than helped by these drugs. Thousands in greater numbers are dead. No demographic has been spared. And further the marketing continues, with pain specialists and vindication groups opposing moves to curtail opioid prescribing, their efforts financed ~ means of the very companies that make these drugs. These forces, coupled by the societal expectation that pain be medicated, threaten every community in this country.
An estimated 10,000 to 20,000 Canadians be in possession of died from opioids since 1995, and every untold number now suffer from enslavement. The federal government must take the go before as guide in dealing with this crisis, in preference than offloading responsibility to the provinces. I propose different concrete measures to that end. Some are squarely inside your purview; others will require annexed co-operation.
We must quantify the tax of the epidemic. In the United States, greater amount of than 16,000 people die of opioids harvested land year; remarkably, there are no corresponding data for Canada. We can’t place what we don’t even estimate. The Public Health Agency of Canada should labor with provinces to develop mechanisms to quantify opioid-allied deaths. These numbers should be common.
Prescription monitoring programs should connect pharmacies in substantive time, in part to identify the slight but important subset of patients seeking prescriptions on account of misuse or resale. These systems be able to also identify physicians whose prescribing falls afoul of righteousness practice or, in some instances, the expressed command. In an era when teens on different continents play video games in substantive time, it’s absurd that pharmacies in the identical town operate in isolation.
Some measures connect specific drugs. Eliminate non-prescription codeine products from Canadian pharmacies. These are unprolific analgesics prone to abuse at noble doses, resulting in deaths from acetaminophen and ASA toxicity. Revoke approval because generic OxyContin tablets, which are easily crushed and disproportionately profit the dealers who sell them. The comprehensible painkiller tramadol is increasingly abused and should be reclassified as a controlled substance, to the degree that its pharmacology demands and as Health Canada contemplated in 2007 prior to being lobbied by Purdue Pharma. Finally, management with fentanyl – an especially perilous drug – should be restricted to patients resolution to return used patches for starting a~ ones.
People with opioid addiction distress more support and less marginalization. They claim greater access to addiction specialists and medications like buprenorphine, side by side with supervised injection sites for those who pick this path. These save lives, to the degree that does the antidote naloxone, which should subsist freely available to anyone who wants it. Health Canada’s critique of naloxone, inexcusably glacial, must subsist accelerated.
Finally, the government should usher in legislation akin to America’s Sunshine Act, illuminating the financial relationships between pharmaceutical companies and doctors, specialty organizations and support groups. The money here flows in one direction, its sole purpose to augment drug sales. This initiative, sure to be opposed, will necessitate provincial co-proceeding.
Some of these suggestions are additional easily implemented than others, but the whole of warrant your consideration. With more than a century Canadians dying every month, there is none time to waste.
Dr. David Juurlink is professor and front part, Division of Clinical Pharmacology, at the University of Toronto.
© 2015 Distributed through Troy Media
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