DANGEROUS DRUGS
Arecent study, published in the journal Addiction, found that the rate of opioidrelated deaths has more than doubled in Ontario since 1991. Opioids include legal, prescription painkillers familiar to every family, such as morphine, oxycodone and fentanyl. There appears to be particular cause for alarm in northern Ontario and among young people.
“The finding that one in eight deaths among young adults were attributable to opioids underlines the urgent need for a change in perception regarding the safety of these medications,” the study concludes.
In 2012, the drug OxyContin came off the Canadian market, replaced with OxyNeo, designed to be more difficult for users to crush or liquefy, to snort or inject. Health Minister Rona Ambrose has suggested Canada could do the same for other prescription drugs, regulating them to require such tamper-resistance.
There is certainly a strong argument in favour of such regulation. But before making more regulations, the government should carefully consider the evidence provided by the OxyNeo experiment first. It should seek evidence about whether feared unintended consequences have come to pass. Do such regulations needlessly make pain medication more costly for those who need it, by making the marketplace more difficult for generics? Do they create a false sense of security among doctors and pharmacists? Do they push addicts to even more dangerous choices on the street?
It is worth weighing those potential consequences against the expected benefits of tamper-proofing. Opioids certainly don’t have to be snorted or injected to be dangerous. Sheer overuse and drug-combining can be lethal. And the black market is ingenious at coming up with ways to circumvent tamper-resistance.
There is much more work that could be done to track prescriptions and avoid duplication; this is one area where Ontario’s slowness in creating electronic health records has cost lives. There is more education that could be done about disposing of medication responsibly. There is more work that could be done to ensure doctors are not over-prescribing, to make sure family members know the signs of addiction and abuse and know how to get help.
And there is more work to be done in changing society’s perception of risk. How many families take a lackadaisical approach to sleeping pills and narcotics on the bathroom shelf, but view the discovery of a joint or a beer bottle in a young adult’s room as cause for alarm?
Tamper-resistance is probably one part of sound government policy on opioids, but it can only ever be a minor part. And like any drug policy, it should be implemented in as informed and prudent a manner as possible.