Pubdate: Mon, 09 Feb 2009
Source: Hamilton Spectator (CN ON)
Copyright: 2009 The Hamilton Spectator
Contact:  http://www.thespec.com/
Details: http://www.mapinc.org/media/181
Author: Kevin Donovan

ONTARIO TO PROBE ABUSE OF PAINKILLER OXYCONTIN

Prescriptions Soaring, Along With Death Rate

Ontario will lead a national probe into the misuse of the painkiller 
OxyContin, a prescription narcotic frequently doled out by doctors 
that can lead to severe addiction and death.

"We need a strategy to tackle this problem," said Helen Stevenson, 
Ontario's assistant deputy health minister in charge of drug 
programs. "We need a solution that really helps people and we need it quickly."

The decision to launch the probe came at a meeting of provincial and 
territorial health officials last Tuesday and was prompted by a 
Toronto Star investigation published the previous weekend.

The Star reported it found OxyContin prescriptions paid for by 
Ontario's public drug plan had tripled in five years, making it one 
of the most popular drugs. Last year, $54 million worth of the drug 
was prescribed, the majority to people on social assistance.

The drug is also prescribed and paid for through private drug 
programs and prescriptions in that market are also on the rise, 
though not as dramatically.

Meanwhile, the Star also found that addiction rates are soaring in 
the province and an estimated 464 deaths in five years have been 
blamed on oxycodone, the drug contained in the popular painkillers. 
That number is steadily increasing each year.

Both revelations, obtained by analyzing health ministry data obtained 
by the Star, seemed to take the provincial health ministry by 
surprise. The Star raised the issues with the ministry through a 
series of questions, but no action was taken until the story was published.

Stevenson said she sees "multiple problems" the review she is leading 
must address. Among them, finding out if the thousands of people 
prescribed the drug really need it.

Critics of the drug say OxyContin, a slow-release form of oxycodone 
intended for people in extreme pain, is given out by doctors too 
freely. A related problem is the issue of double doctoring, people 
who visit multiple doctors complaining of pain symptoms to obtain the 
drug for resale on the street. Known as "hillbilly heroin" by 
abusers, a $4 OxyContin pill has a street value of up to $45. Though 
intended for slow release over 12 hours, people addicted to the drug 
crush the tablets and either snort them or inject a liquid solution 
of the drug into their veins for an instant, heroin-like high.

Stevenson said she would like input into the review from Purdue 
Pharma, the maker of OxyContin.

A spokesperson for Purdue told the Star the company does its best to 
inform the public about the risk of addiction by educating doctors. 
In Canada, however, several lawsuits have been filed by patients 
saying they were not properly warned of the risks of addiction.

|In the United States in 2007, Purdue and three senior executives 
pleaded guilty to downplaying the risks of addiction and paid a 
court-approved settlement of $635 million, agreeing to provide better 
warnings of the drug's addictive nature. That settlement had no 
effect on how the Canadian product is marketed. Purdue spokesperson 
Randy Steffan said all federal guidelines are followed.

The new national review will look at the U.S. experience and also 
look at how other Canadian provinces have dealt with it. The Star 
found that in Ontario, there's no way for a doctor to find out if his 
patient has recently been prescribed OxyContin or another 
opioid-based painkiller. In British Columbia, doctors can check a 
patient's previous prescriptions online.

"Doctors can get real-time access to the database," said Dr. Heidi 
Oetter, registrar of the British Columbia College of Physicians and 
Surgeons. They also have special banknote quality prescription forms 
that doctors must use if they are going to prescribe a narcotic. 
Oetter said the system helps reduce abuse. In Ontario, there are no 
special prescription forms for narcotic drugs.

An Ontario health ministry spokesperson said Ontario is working on a 
plan for a computer-based system that will provide an "electronic 
health record" by 2015. That system would allow doctors to check the 
prescription history of a patient.

But Stevenson said her review aims to solve at least some of the 
problems this year. "This is a very immediate problem."
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MAP posted-by: Keith Brilhart