UPFRONT | Roundup Take 5 Addiction experts call for national opioid strategy TORONTO – Canada needs a comprehensive na-tional strategy to curb ram-pant overprescribing of opioids and to reduce esca-lating numbers of deaths caused by overdoses of the powerful narcotics, addic-tion experts say. Writing in a recent edition of the Canadian Medical Association Journal , Dr. Ben-edikt Fischer of the Centre for Addiction and Mental Health (CAMH) and co-au-thors say an estimated 2,000 Canadians died from opioid overdoses in 2015, and many provinces are on track for an even higher number of deaths in 2016. “It’s a real public health disaster,” Fischer said in an interview. “Over the last 10 years, we’re looking at some-where between 10,000 and 20,000 dead people in Can-ada just from opioid over-doses alone.” In a separate report, the Toronto centre urged Ot-tawa to launch a review of all prescription painkillers sold in Canada and said high-dose opioid medications should be pulled from the market. Worldwide, Canadians are the second-highest consum-ers of prescription opioids like oxycodone, hydromor-phone and fentanyl, after the U.S. “We have hundreds of thousands of people now who are dependent on these drugs because of misuse or overpre-scribing or excessive expo-sure,” said Fischer, laying the blame on the medical system that sees too many physicians prescribing the drugs for chronic pain, when research “clearly shows” it is not effi-cacious for that kind of pain and can actually do harm. Medical evidence suggests opioids should be restricted to patients with acute pain, such as that related to cancer or following surgery, and should be given in limited doses and for a short duration to prevent dependence, as well as accidental overdoses. But instead of focusing on overprescribing – the major driver of opioid misuse and abuse – Fischer said govern-ments and the medical sys-tem have instead tinkered with downstream effects, such as increasing access to naloxone, a drug that can reverse an opioid overdose, and treatment of dependency with another medication called suboxone. While Ontario has delisted Oxycontin on its provincial drug benefit program, that move merely shifted the problem to other prescrip-tion opioids like morphine and fentanyl patches, said Fischer. However, the Ontario gov-ernment announced in July it would remove those high-dose opioids from its insur-ance plan next year, except for patients requiring the medications for palliative care. “Regulators and authori-ties have been watching this problem not just unfold but grow and get worse and worse, and didn’t really take effective action,” said Fischer. “It is late – but not too late – to move toward reducing the toll of opioid overuse and abuse in Canada,” Fischer said. – Sheryl Ubelacker, The Canadian Press WHAT’S ONLINE Canadianchiropractor.ca Have you checked out the Canadian Chiropractor website lately? Here are some pages that are getting lots of traffic online. Events Calendar A listing of upcoming events and conferences in the health care world Video series featuring chiropractors with unique and interesting practices Clinic Files Digital Edition Missed an issue of Canadian Chiropractor ? Check out the digital edition archive and view the magazine through your desktop or tablet. www.canadianchiropractor.ca 6 Canadian Chiropractor December 2016
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