Pubdate: Tue, 21 Nov 2006
Source: Winnipeg Free Press (CN MB)
Copyright: 2006 Winnipeg Free Press
Contact:  http://www.winnipegfreepress.com/
Details: http://www.mapinc.org/media/502
Author: Sheryl Ubelacker, Canadian Press
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

PRESCRIPTIONS BECOMING ILLICIT DRUGS OF CHOICE

Overtaking Heroin In Some Cities

TORONTO -- Heroin is no longer the drug of choice among many 
substance abusers in Canada, with prescription narcotics such as 
morphine and OxyContin now taking its place, says a study of street 
users in seven cities across the country.

Researchers found that heroin remains the No. 1 illicit drug only in 
Vancouver and Montreal. In the five other cities -- Edmonton, 
Toronto, Quebec City, Fredericton and Saint John, N.B. -- more often 
than not, getting high means grinding up and injecting prescription opioids.

Furthermore, the switch to highly addictive prescription narcotics 
among street users likely represents just the tip of the iceberg, 
said lead author Benedikt Fischer, an addiction researcher at the 
University of Victoria. If the general population were factored in, 
he suspects the numbers would be much higher.

"We have to and will do research in Canada as to what is the shape 
and size of the iceberg below the tip that we've been showing with 
our little paper," he said Monday. "There are indications that it 
might be quite enormous."

"But its potential in terms of size and implications is of a nature 
that we better look at it and start thinking about what do we really 
need to do about it."

The study, published in Tuesday's issue of the Canadian Medical 
Association Journal, showed that heroin in 2005 wasn't even a factor 
among injection drug abusers in Fredericton, and it was barely 
noticeable in Edmonton and Quebec City. "So that was quite a shocking 
finding for us," said Fischer, who also works at the Centre for 
Addiction and Mental Health in Toronto. "The dramatic changes are 
really what's happening around the opioids."

"This study for the first time systematically documents this for 
street-drug-use populations across Canada," he said of the research, 
which compares drug favourites among street users in 2001 and again 
in 2005. "This is the first research that shows this trend, or the 
real picture, across Canada."

While heroin is produced in countries like Afghanistan and typically 
imported and distributed by organized crime organizations, which are 
subject to prosecution, "opioids come in some fashion directly or 
indirectly from a doctor's office, they're produced legitimately by 
pharmaceutical companies," he said.

"So we have very different problems here in terms of supply."

Supplying addicts with such narcotic painkillers as Demerol, 
Dilaudid, OxyContin and Percodan has given rise to break-ins at 
doctors' offices and pharmacies, double-doctoring (seeking 
prescriptions from different doctors) and more generalized theft to 
turn proceeds of crime into money for drugs.

"The main source is diversion," explained Fischer, so that drugs 
intended for legitimate use in people with severe pain, such as 
terminal cancer patients, are diverted to those merely seeking to get high.

Diversion is relatively easy in Canada, compared to many other 
countries, he noted. While most provinces have some sort of 
prescription-monitoring database so doctors and pharmacies can check 
an individual's drug purchases, most are incomplete or not equally 
accessible by health professionals. There is no national database.

As well, Canada "is a very prescription-happy society," Fischer said. 
"Canada is among the top consumers of prescription opioids." But 
strictly controlling opioids or curtailing them completely to avoid 
illicit use is not the answer, he said, since many people suffering 
from pain have legitimate need of the drugs.
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MAP posted-by: Beth Wehrman