OTTAWA — The College of Physicians and Surgeons of Ontario claims there is a health crisis in the province — and in many other jurisdictions in Canada — resulting from the inappropriate prescription and misuse of drugs such as morphine and codeine.
The college released on Wednesday a study called Avoiding Abuse, Achieving a Balance, which includes 31 recommendations that call on health-care professionals, educators, law enforcement and government to work together to curtail the illicit use of opioids.
According to the college, Canada is the world's third largest per capita consumer of opioids. The report cites that misuse accounts for an increasing number of deaths, alarming rates of addiction and devastating consequences in our communities.
Among the statistics in the report, the college reveals the prescription drug OxyContin (oxycodone) is the most easily procured opioid for non-medical use in Toronto's street drug scene; the number of admissions at the Centre for Addiction and Mental Health (CAMH) seeking treatment for opioid detoxification related to controlled-release oxycodone increased from 3.8 per cent in 2000 to 55.4 per cent in 2004; and among Ontario high school students, one-fifth reported using opioids or at least one prescription drug without a doctor's prescription, in 2009.
Dr. Rocco Gerace, college registrar, says there is no way for authorities to know the real extent of the problem because there is no centralized system for the monitoring of prescription drugs in Ontario.
Gerace said patients can visit multiple doctors and pharmacists with the same prescription.
The sense is that the vast majority of the drugs on the street are obtained via prescription, said Gerace. Whether it is deception of health-care providers, inappropriate prescribing or . illegal activity on the part of health-care providers, we have no way of quantifying that.
However authorities are able to trace the number of prescriptions filled by doctors — and the numbers are staggering, according to the report.
The report reveals that prescriptions for oxycodone increased 850 per cent between 1991 and 2007, and cites data from the Office of the Chief Coroner of Ontario which shows that between 2002 and 2006, opioid-related deaths increased by 49 per cent. Deaths due to oxycodone increased 240 per cent between 2002 and 2006.
Among the college's 31 recommendations:
- Significantly enhance the training and ongoing education of health-care providers;
- Improve education and awareness of the public with a particular emphasis on high-risk communities;
- Create a co-ordinated, accessible system for the treatment of pain and addiction;
- Make all opioid prescription information available to all prescribers and dispensers by establishing a Drug Information System; and
- Facilitate information-sharing between health-care professionals, institutions and law enforcement agencies.
Gerace said Ontario should look to other provinces that have prescription drug monitoring systems, such as B.C., Saskatchewan and Nova Scotia.
However, he said it was critical that all stakeholders — doctors, pharmacists, police, educators and politicians — co-ordinate their efforts to stop the illicit use of these drugs.
Polling conducted on behalf of the college found that 73 per cent of Ontario respondents said they and/or a family member had been prescribed an opioid in the last two years.
One-quarter of Ontario residents thought that a central electronic system for drugs was in place in the province when no such system exists.
And 90 per cent of Ontarians said they believed a Drug Information System would be beneficial in preventing the abuse of prescription drugs.
Seven hundred fifty Ontario residents were polled for the survey. Its findings are considered accurate within plus or minus 3.58 per cent, 95 times out of 100, according to The Strategic Counse
By Giuseppe Valiante
September 8, 2010