Opioid overdose deaths continue to rise in Canada despite removal of OxyContin

Opioid overdose deaths continue to rise across Canada, forcing federal and provincial authorities to respond to this growing epidemic.

In Ontario alone, these drugs have killed nearly 2,500 people between 2011 and 2014.

“Right now, the one that we’re seeing the greatest increase in is the use of Fentanyl,” said Minister of Health Jane Philpott. “That’s a big concern for us.”

This heightened concern comes after the 2012 removal of OxyContin from the Ontario Drug Plan, a move many believed would reduce the amount of opioid overdose deaths in the province.

While Oxycodone-related overdoses decreased by 30 per cent, the Centre for Addiction and Mental Health says overall opioid fatalities increased by 24 per cent.

“There are so many products out there and so many prescriptions floating around, that I don’t think the removal of OxyContin, by its manufacturer, really made much of a difference,” said David Juurlink, Drug Safety Researcher at Sunnybrook Health Sciences Centre.

Two new opioids climbed the ranks, further casting light on the over-prescribing of these pills. A report published by the Centre for Addiction
and Mental Health (CAMH) researchers states while OxyContin prescriptions fell 44 per cent between 2010 to 2013, Hydromorphone increased by 56 per cent and Fentanyl by nearly 16 per cent.

Juurlink says there are millions of people in North America currently on these painkillers, calling it Canada’s biggest drug safety problem.

“It’s a practice that we now know is associated with more harm than benefit for a good number of patients that we do it for,” he explained. “It’s almost unconscionable that it took us two decades to figure this out, we have to stop doing this or people are just going to keep dying.”

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Quick Facts

• Ontario has seen 2,471 opioid-related overdoses between 2011-2014
• Oxycodone overdose deaths decreased by 30%, while overall opioid fatalities increased by 24%
• Between 2010-2013, OxyContin prescriptions fell 44%, Hydromorphone increased by 56%, Fentanyl by nearly 15%
• In a 2012 survey, 410,000 Canadians reported abusing prescription drugs like opioid pain relievers

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Addiction facilities are also seeing an increase in patients seeking treatment for opioid abuse.

“About 20 to 30 per cent of our opioid addicts coming in are addicted to a prescription they received in the medical field,” said Joshua Montgomery, Director of Nursing and Admissions at Bellwood Health Services.

Chris Fagan is a recovered Fentanyl addict, who was unaware of the impacts the drug could have on him.

“I got to the maximum that my doctor was going to prescribe to me,” he said. “My pain levels never got worse, but my addictions to opioids did, so I had to self-medicate myself to keep with the withdrawals.”

His doctor prescribed him the painkiller to manage his migraines following a 2007 car accident.

“I assumed by him giving me the drug, it was okay,” Fagan said.

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Number of Opioid toxicity Deaths by Drug in Ontario

Office of the Chief Coroner and Ontario Forensic Pathology Service

Year	Codeine	Fentanyl	Heroin	Hydromorphone	Methadone	Morphine	Oxycodone
2011	28	104	33	42	109	68	169
2012	35	116	40	65	94	84	146
2013	49	119	46	86	127	109	122
2014	44	149	74	94	102	110	107

 

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Juurlink says the over-prescribing of painkillers by doctors is a big problem that needs to be addressed.

“Part of the solution to the epidemic that we face is for doctors to dial back on how often we start patients on these drugs,” Juurlink said. “We certainly have to prescribe them at lower doses than we have.”

Now Health Canada says they’re taking multifaceted steps in addressing the opioid epidemic, including investing in new guidelines and tools for doctors that would address over-prescribing.

“I think there is considerable work that needs to be done in terms of better guidelines, better training and making sure the prescribers are aware of the potential for abuse,” said Minister Philpott.

The department says they’re also taking an unprecedented step in expediting a review of Naloxone, a synthetic drug known to reverse the effects of opioid overdoses, and making it more accessible to first responders across the country.

Minister Philpott said she’s confident the drug will receive non-prescription status, and be made available by March 19.