When Health Minister Leona Aglukkaq announced last week that the federal government would not interfere in the drug approval process to keep a generic form of the painkiller OxyContin off the Canadian market, provincial health ministers were understandably disappointed.
The health ministers had requested at least a delay, if not an outright ban, on generic oxycodone until regulators can look into how the drug is abused.
A recent commentary by EvidenceNetwork.ca expert advisers Irfan Dhalla and David Juurlink (which can be found on the Troy Media website) says Aglukkaq was correct in saying the law doesn't allow her to withhold approval of a generic formulation just because of the risk of misuse. "But when the legal and regulatory framework results in a situation in which more than a dozen Canadians die each week because of an accidental prescription drug overdose, it needs to be changed," the authors said.
Provincial ministers and others have legitimate cause for concern. Ontario Health Minister Deb Matthews said in a statement following Aglukkaq's decision that OxyContin has led to a five-fold increase in oxycodone-related deaths.
Dhalla and Juurlink note that overdose deaths involving prescription medications in Canada now outnumber HIV deaths by a large margin, and add that some estimates indicate prescription drug overdoses have killed 100,000 North Americans over the past 20 years (including a few high-profile victims such as actor Heath Ledger). That doesn't count the lives that have been damaged by misuse of these medications.
The experts make some wise recommendations for dealing with this issue, including suggesting a law requiring that all opioids be manufactured in a way that makes them more difficult to tamper with. They also urge provincial governments to speed up the development of online databases so doctors and pharmacists can see if patients are trying to obtain opioids from multiple prescribers.
The issue of prescription drug addiction is one to which the government cannot turn a blind eye. The government's hands might have been tied on banning oxycodone, but surely there are other steps that can be taken to combat the problem.
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