By Jennifer Thurbide
As provincial officials were announcing the delisting of a popular prescription narcotic last week, representatives from Northwestern Ontario continued to pressure the government for improved services related to addiction and treatment in the wake of what one leader called an impending “health catastrophe”.
On February 17, 2012 the province announced it would be removing the painkiller OxyNEO and its predecessor OxyContin from the Ontario Drug Benefit program and would soon require doctors who want to prescribe the drug for their patients to request access through the Exceptional Access Program. Those with current prescriptions would receive one month of coverage before being automatically covered for OxyNEO until February 2013.
The government says this new process is in an effort to limit prescriptions and has joined Saskatchewan and Atlantic provinces who have made similar moves to delist the drug. Departmental communication used to inform the public of the change cited increased rates of opioid prescribing contributing significantly to opioid-related harms and deaths as one of the reasons for the move and note that the number of prescriptions in the province rose by 900 per cent between 1991-2009. “Each year in Ontario, between 300 and 400 people die from overdoses involving prescription opioids. The opioid most commonly found on post-mortem analyses in recent years is oxycodone,” said the memo.
However, regional leaders say an impending drug crisis is about to take hold in Northwestern Ontario as members of First Nations and isolated communities who have been battling prescription drug addictions will face a shortage of supply without adequate treatment programs and facilities.
Questioning government officials on their plans for the future Member of Provincial Parliament for Kenora-Rainy River Sarah Campbell addressed Queen’s Park and Health Minister Deborah Mathews on February 21, 2012.
“In my riding the community of Cat Lake has declared a state of emergency as a result of prescription drug abuse,” informed Campbell. “Other First Nations communities report addiction rates as high as 50 to 70 per cent. On [February 17] it was announced that Oxycontin will no longer be available in Canada. While this should help prevent further addiction it does little to help those who are already addicted. What is this government’s plan to assist First Nations communities dealing with staggering rates of addiction?”
Responding to the question Mathews confirmed that the province was aware that OxyContin will no longer be manufactured by Purdue Pharmaceutical and “that there is a new drug that is far less likely to be used for illicit purposes”. Oxycontin was removed from circulation on February 29, 2012 by manufacturer Purdue Pharma to be replaced by the newly formulated drug that is more difficult to crush and is less likely to be abused through injecting or snorting.
“We do have an issue that we are working to address,” continued the minister. “The federal government, of course, is responsible for delivering health care in those First Nations communities. But this is an issue of concern, and I want to assure the member opposite that we are looking into it.” Mathews also noted that the previously released addictions and mental health strategy addresses prescription narcotics.
After the exchange Campbell called the minister’s response non-committal pointing to lengthy waiting lists for treatment centres and the lack of a withdrawal strategy for users.
“First Nations have been asking for assistance for years but their requests have fallen on deaf ears…First Nations are citizens of this province and they’re crying out for help. Leaders in the north are terrified of what may happen if entire communities are forced to go off the drug cold turkey. Time is of the essence. When will this government release a comprehensive strategy to stop this crisis,” questioned Campbell.
First Nations in Crisis
Leaders of the region’s Aboriginal political organizations are also demanding government action going so far as to warn of a “health catastrophe” that will result as the ultra-addictive opiate is removed from circulation.
Nishnawbe Aski Nation Deputy Grand Chief Mike Metatawabin stated earlier this month that a massive opiate withdrawal is looming without adequate support.
“Potential for a mass involuntary opiate withdrawal is looming. The number of NAN First Nation community members addicted to OxyContin at risk for painful withdrawal as a result of the change is staggering,” said Metatawabin. “The problems are intensified in the remote northern communities for those who are addicted to OxyContin and do not have access to drug treatment programs. It is time for both levels of government to respond with programs and services that are urgently required to implement emergency strategies.”
The NAN Prescription Drug Abuse (PDA) Task Force, Chiefs and NAN Executive Council have been applying pressure on Health Canada and the Ministry of Health and Long-Term Care to respond to repeated requests for assistance since the NAN Chiefs- in-Assembly declared a State of- Emergency in November 2009.
“In the absence of any regular treatment, a public health catastrophe is imminent, as there are thousands of addicted individuals with rapidly shrinking supplies – likely leading to massive increases in black market prices, use of other drugs, needle use/sharing, and crime,” said Dr. Benedikt Fischer, a senior scientist at the Centre for Addictions and Mental Health.