Doctors warn of opioid refusals
OTTAWA • Millions of people taking prescribed opioids to relieve chronic pain could have trouble obtaining the medicine now that the Liberal government has jettisoned a plan to make cheap painkillers tamper-resistant, says a national coalition of pain and addiction physicians.
In a letter to Health Minister Jane Philpott, the group says a growing number of doctors are abandoning or refusing to write opioid prescriptions for pain-stricken patients because of concerns the drugs might end up on the illicit market and worsen the spreading epidemic of opioid overdoses and deaths among street-drug users and others.
“In the interests of patient and public safety for all Canadians, we urge Health Canada to reconsider your decision,” it says.
The appeal coincides with a flurry of other calls for broad government action on Canada’s opioid crisis.
A recent letter signed by more than 200 physicians and health officials asks Ontario Premier Kathleen Wynne and Health Minister Eric Hoskins to devise an emergency plan to deal with an anticipated explosion in opioid overdoses this year.
British Columbia, where more than 200 people have fatally overdosed on fentanyl this year, has already declared a public health emergency.
And last week, a U.S. coalition led by pharmaceutical companies accused Health Canada of abandoning its leadership in the global fight against prescription opioid abuse by failing to enact the draft regulations to make generic oxycodones tamperresistant.
An estimated six million people — about one in five Canadians — suffer moderate to severe chronic non-cancer pain and rely on opioids to persevere, making Canada the world’s No. 1 per-capita consumer of opioids.
OxyContin, a brand-name version of oxycodone and one of the most abused drugs in history, was voluntarily replaced by its manufacturer in 2012 with a tamper-resistant version called OxyNEO, which is tougher to crush, snort or inject, the preferred methods of use by street addicts in search of a quick, morphine-like high.
People hooked on OxyContin then turned to generic versions of the drug that could still be tampered with.
In response, Health Canada, under the former Conservative government, drafted regulations that would have forced opioid manufacturers to make their oxycodone products, and eventually all opioids, tamper-resistant.
But the Liberals ditched the plan this month.
“It would be wise if it worked, but the result is that introduction of tamper-resistant products actually only serves to increase the use of other products on the market,” Philpott told the House of Commons’ health committee April 11.
Cost was another issue. Tamper-resistant formulations are two to four times more expensive, deputy minister of health Simon Kennedy told the committee.
Dr. Roman Jovey, medical director of CPM Centres for Pain Management in Mississauga, Ont., and author of the April 25 letter to Philpott, acknowledges that making all opioids tamper-resistant will be more expensive.
“However, this is a unique case where the social ‘costs’ of maintaining the status quo may be much higher than the savings from drug costs alone,” he writes in the letter, endorsed by 37 physicians from across Canada, mostly pain and addiction specialists.
WE URGE HEALTH CANADA TO RECONSIDER YOUR DECISION.