National opioid strategy urged to rein in over-prescriptions, overdoses

‘Public health disaster’ not being addressed effectively by regulators, say experts

Experts are calling for a comprehensive national strategy to address rampant opioid over-prescription and deaths from overdoses, according to a report in the Hamilton Spectator.

Citing a recent piece written by Dr. Benedikt Fischer of the Centre for Addiction and Mental Health (CAMH), the article said around 2,000 Canadians died from opioid overdoses in 2015, with many provinces on track for an even larger death toll this year.

“It’s a real public health disaster,” Fischer said in an interview, claiming that opioid overdoses have caused between 10,000 and 20,000 deaths in Canada over the last 10 years.

A separate report from the Toronto centre urged Ottawa to review prescription painkillers sold in Canada and remove high-dose opioid medications. “We have hundreds of thousands of people now who are dependent on these drugs because of misuse or overprescribing or excessive exposure,” said Fisher, accusing the medical system of doling out the drugs too readily for chronic pain, when research “clearly shows” it is not effective for that kind of pain and can actually be harmful.

Based on medical evidence, opioid treatment should be restricted to cancer-related, post-surgical, or other types of acute pain. Only limited doses should be administered for a short duration to avoid dependence and accidental overdoses.

Fischer said that instead of focusing on over-prescription, authorities have been addressing downstream effects: for example, regulators have increased access to naloxone, which can reverse an opioid overdose, and suboxone, which is used to treat opioid dependency.

Oxycontin has been delisted from Ontario’s drug benefit program, but Fischer said that only caused patients to seek other prescription opioids like morphine and fentanyl patches. However, the Ontario government announced in July that it would strike off those high-dose opioids from its insurance plan next year, granting exemptions for patients that need them for palliative care.

“Regulators and authorities have been watching this problem not just unfold but grow and get worse and worse, and didn't really take effective action,” said Fischer.

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