Health Canada must withdraw its disastrous opioid policy
While everyone is focused on the pandemic, there are two other intertwined health crises impacting Canadians. One is increasing deaths from drugs and the other is increased suffering for those with chronic pain caused by the failed government attempt to deal with the overdoses.
The U.S. government erroneously determined prescriptions were turning people into addicts or were being diverted to the black market. The Center for Disease Control ordered that opioid prescriptions be drastically reduced for people in pain. It later admitted its data was wrong while all sorts of medical and research specialists lambasted their edict against pain prescriptions in the medical literature and other publications. Sadly, nothing has changed.
Continuing medical research in the U.S., however, is demonstrating the foolishness of these attempts to deal with increasing overdose deaths. Overdoses and deaths have been rising for the past number of years while legitimate prescriptions for pain medication for those suffering chronic pain have declined.
Health Canada copied the American plan with its own prohibition against prescribed pain medications. Pain patients are suffering, some have attempted suicide and others are getting their drugs from street dealers and/or the dark web. Unfortunately, few if any Canadian academics have denounced Health Canada’s strategy but we do have a task force set up to investigate. They were supposed to release their final report at the end of this past March.
In the past few weeks, two U.S. studies and an Australian study, have exposed the flaws in the rationale for the prescription ban while a fourth study from 2017 adds further refutation.
Researchers at Case Western University in Cleveland looked at the relationship between prescribed opioids and injury deaths from 2006 to 2017. The rationale for the ban on prescriptions was that they caused injuries and deaths. In the U.S., opioid prescriptions began to decline from 2012 on as they did in Canada while injury deaths steadily increased in both countries. Their conclusion was that “in every state examined, there was no consistent relationship between the amount of prescription opioids delivered and total injury-related mortality or any subgroups, suggesting that there is not a direct association between prescription opioids and injury-related mortality.”
Boston University physicians looked at the impact of first time prescribed opioids given to young people between the ages of 11 and 25 from 2006 to 2016 (over 3 million). Again, the rationale for the prescription ban is that prescriptions may turn young people into addicts. They found this not to be the case and concluded that; “Among United States youth, complications after an initial opioid prescription appear to be relatively rare and appear to be associated with mood/anxiety disorders, substance use, comorbid substance use disorders, and prescriptions involving long-acting opioids or long durations.”
A study just published out of Australia looked at 1,514 chronic pain patients who were followed from August 2012 to December 2018. Only 0.5 per cent to 1.4 per cent of them diverted pills at some point to others who were not prescribed them. So much for the accusation that pain patients are giving their drugs to others for them to get hooked.
The gateway drug assumed to be the cause of addictions has been hypothesized by the CDC and Health Canada to be prescribed opioids. According to a 2017 study, this is false. A study done by psychiatrist at Washington University in St. Louis determined that heroin is the gateway drug rather than prescribed opioids. That study involved close to 6,000 subjects from 2010 to 2016. It concluded, “the use of heroin as an initiating opioid has grown at an alarming rate.”
There is no reason to suspect Canadian studies would find anything different. It is time that Health Canada do two things. First, it must withdraw its disastrous prescribing policy and allow pain patients to be properly treated based on their unique needs. That should be determined between the needs of the patients and their doctors.
Second, it needs to look at more productive strategies to deal with overdose deaths other than passing out naloxone kits to reverse the effect of overdoses other than depriving pain patients of their medicine. This is not working, but decriminalizing of drugs as Portugal has done has solved many of the problems we are facing.