Pubdate: Sat, 06 May 2017
Source: Toronto Star (CN ON)
Copyright: 2017 The Toronto Star
Author: Susan Delacourt
Page: IN5


No one plans to acquire a drug problem over the course of a lifetime -
and neither do governments.

Yet Prime Minister Justin Trudeau's government is nearing its midpoint
in power surrounded by drug problems: serious issues to confront about
legal, illegal and almost-legal substances. Two years ago, as they
campaigned for office, most of these issues were not high (pardon the
pun) on the Liberals' agenda.

First, the legal drugs. The federal Liberals' old allies at Queen's
Park threw a deliberate curveball at Ottawa in the latest provincial
budget when they introduced pharmacare for all Ontario health-card
holders under the age of 25.

Ontario Health Minister Eric Hoskins made it very clear in the wake of
the budget announcement that this was intended as a call to action for
the Trudeau government in Ottawa. "I think if there is one message
today it's that this is possible," Hoskins said, promising to keep up
his advocacy for a nationwide program. "It's doable."

Health-care reform advocates are also keen to see this as a historic
tipping point toward a future with national pharmacare in it.

But pharmacare is not anywhere near the top of the federal
government's to-do list at present. Health Minister Jane Philpott has
been saying repeatedly that her mandate, as far as it concerns drug
prices and availability, is limited to getting better deals within the
status quo.

The Commons health committee has been studying the idea of a national
pharmacare program off and on since late 2015. As recently as
February, in fact, the committee was hearing from experts on how a
national drug plan might fit into the Constitution. But neither
Philpott nor her government has shown much enthusiasm for the
committee's work - at least so far.

Ontario's gambit may change that, basically forcing the federal
Liberals to get serious about pharmacare before the next election.

Moreover, this week's census report - showing that Canada now has more
seniors than children - could also factor into those political
deliberations. Seniors are the biggest users of pharmaceuticals in
Canada and also the most likely to show up at the ballot box. As the
Toronto Star's Thomas Walkom has noted, if pharmacare makes sense for
young people in Ontario, it also makes sense for seniors. Now that the
door has been opened to pharmacare, it's going to be hard for Ottawa
to close it.

Meanwhile, apart from all the discussion over legal drugs, there are
the illegal - and increasingly dangerous - ones for the Liberals to
worry about. Deaths and overdoses from opioid use are now being called
a "public health crisis" by the federal government, and an increasing
amount of Philpott's time is being taken up with how to tackle it.

"This is not a political or a partisan issue. This is one of the most
serious public health crises that we have faced in this country,"
Philpott told the Commons health committee last month. Two years ago,
though, opioid abuse wasn't mentioned in the official mandate letter
that Philpott received when she was sworn into cabinet.

Really, the only drug that figured prominently into the Liberals'
platform in 2015 was marijuana - specifically, its legalization, which
only recently got underway. People have noticed, though, that the tone
around marijuana has markedly changed - it's become less about
liberalization of drug laws and more about stricter controls and
discipline. Funny how power has changed that discussion.

Speaking of power shifts, I've been watching a lot more of CNN since
the U.S. presidential election. One big surprise has been the
commercials - I had no idea that Americans were suffering from so many
ailments that required pharmaceutical intervention.

Drugs, legal and illegal, seem to be rampant all over the States. I
was reading some profiles of typical Donald Trump voters recently and
was surprised by the ways that many of their lives had plunged into
despair after pharmaceutical drug abuse.

"Recent analyses suggest a relationship between Trump support and
opiate overdoses in key states and provide potential explanations for
why Trump received so much support in America's new post-industrial
'heroin beltway,'" said a research brief from Penn State University in
late 2016.

Given the Trudeau government's ongoing preoccupation with Trump's
America - and its determination not to see Canada's politics go down
the same road - the Liberals may be paying closer attention these days
to the way drugs and politics are turning into a powerful,
unpredictable political mix.

That's the thing about drug problems. You may not see them coming, but
they can quickly become all-consuming, for individuals and for
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