Significant numbers of Canadians have become hooked while taking prescribed drugs for legitimate pain problems, experts say, with some overdosing while under a doctor’s care.
Nov 14, 2011 – 6:30 AM ET | Last Updated: Nov 13, 2011 3:49 PM ET
Hundreds of people across Canada are dying every year from overdoses involving OxyContin, newly divulged coroners-office figures indicate, underlining the toll taken by the country’s epidemic of narcotic-painkiller dependency.
“I would say it’s one of our biggest silent killers right now,” said Deborah Cumming of the Canadian Centre on Substance Abuse. “It’s a legal substance that serves a great purpose … but now we’re seeing this diversion, we’re seeing this abuse and misuse, so what do we do? It’s very politically sensitive.”
Despite a persistent popular image, not all buy the medication illicitly on the street, extracting the active ingredient before snorting or injecting it — a sub-culture fuelled in part by bikers and other criminals. Significant numbers have become hooked while taking prescribed drugs for legitimate pain problems, experts say, and an ill-fated few have overdosed under a doctor’s care, as excessive quantities coursed through their veins.
The Ontario government recently joined a handful of other provinces in implementing a system to closely monitor prescription of opioids, with the hope of at least detecting addicted patients who obtain drugs from multiple doctors.
Ontario has previously revealed that the number of its residents succumbing to OxyContin-related overdoses soared from 35 in 2002 to 143 in 2009, more people than drown every year, and about equal to those killed by HIV, said Dr. Andrew McCallum, Ontario’s chief coroner.
Total yearly deaths from abuse of all prescription opioids have risen to 350, the same number who lose their lives in road accidents.
Few other provinces have parsed out such data, but the National Post obtained figures from three jurisdictions’ coroners.
In B.C., deaths tied to oxycodone tripled to 37 from 2004 to 2009. New Brunswick saw between three and 10 overdose deaths a year attributed to oxycodone, or that drug and others, between 2005 and 2009. Nova Scotia had at least six and up to 11 solely oxycodone-related deaths a year from 2007-2010 and as many as 48 attributed generally to opioids, including oxycodone.
That translates into more than 250 deaths related at least in part to the drug in the four provinces in 2009, the most recent year for which all have statistics.
The victims include Janice Stoltz, an Edmonton pediatric nurse first prescribed OxyContin in the late 1990s for the nagging pain of fibromyalgia. Over the next few years, she seemed to become increasingly dependent on the medication, often sinking into a “fog” under its influence, her daughter, Dana Dmytro, recalls.
In 2002, the 40-year-old single mother was found dead next to her bed, a coroner’s report later saying her breathing had been brought to a halt by the high levels of OxyContin, less-potent codeine and two anti-anxiety drugs in her bloodstream. The autopsy also found five undigested, 80 mg. OxyContin pills in her body.
“It is absolutely the worst tragedy possible,” says Ms. Dmytro, a plaintiff in a class-action lawsuit against Purdue, who described her mother as a normally smart and independent woman. “She became an unrecognizable person who was not my Mom any more, and then she died.”
The addiction and fatal accidents have arisen against the backdrop of Canada’s growing love affair with prescription opioids — natural or synthetic opium-like drugs that provide unparalleled pain relief, but also can be powerfully habit forming.
Canada was second in the world only to the U.S. in its consumption of the medications from 2007 and 2009, ingesting three times the volume used in the United Kingdom and 20 times that consumed in Japan, according to the International Narcotic Control Board.
Yet pain-treatment specialists argue that, despite the widespread problems, millions of Canadians are still going untreated for chronic, non-cancer pain. If doctors carefully screen out patients with addiction potential and supervise people closely, medications like OxyContin can be a godsend for those coping with chronic pain from conditions like diabetes or arthritis, or recovering from injuries or surgery, they say.
“Chronic non-cancer pain is a huge problem in Canada,” said Dr. Brian Goldman, a pain expert at Toronto’s Mount Sinai Hospital. Some in the field worry that further restricting the prescription of opioids would only create a chill among doctors, depriving patients who truly need help.
Still, the dangers of the drugs are hard to ignore. Breakaway Addiction Services in Toronto has seen a “huge” spike in clients hooked on OxyContin and other prescription opioids lately, including people “from every class, every nationality, every income bracket, every professional group,” said Bob Martel, a clinic manager.
For many, the habit starts after being prescribed the “highly addictive” drug to treat pain from a work injury or operation, though many clients have underlying emotional troubles as well, he said.
“For some people it not only relieves physical pain, I think it relieves their psychic pain or spiritual pain,” said Mr. Martel. “It just flattens you out, and everything is all right.”
Ontario addiction programs saw the number of prescription-opioid cases rise steadily in the late 1990s, a study reported last year, and it seems the upward trend has continued since. The number of calls to Ontario’s drug and alcohol help line about narcotic painkillers — mostly OxyContin — climbed to 4,700 in the year that ended last month, up from 2,700 in 2008-09, according to ConnexOntario, which runs the line for the provincial government. Opioid calls now outnumber cocaine, at 4,400.
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