'It's ruining people's lives': province looks at restricting Oxy

From the Sault (Ont.) Star:
First, it takes away the pain. Then it takes over your life.

Pharmacist Jon MacDonald has seen the astonishing rise in opioid painkillers such as Oxycontin over the last decade, and welcomes changes the provincial government wants to introduce to how they're prescribed and dispensed.

"If doctors are tracked, and know they're tracked, they'll prescribe a little more responsibly. And the same for pharmacists," said MacDonald, operator of the Medicine Shoppe on Second Line West, who until this year was regional spokesperson for the Ontario Pharmacists' Asoociation.

Ontario's Health Ministry wants to use a computer tracking system that would monitor how much of a drug is going out and send alerts if a prescription is received two days in a row.

MacDonald said it shouldn't be difficult, as anyone with a health card in Ontario is already entered into a database when they get prescriptions filled. The missing link right now is that nobody is actually monitoring what's going on, he said. ...more

Abuse of prescribed opiate painkillers on rise, research shows

From CBC News:
A growing number of Canadians are becoming addicted to prescription painkillers such as Tylenol 3 and OxyContin, say researchers who fear the problem could lead to more deaths.

In many Canadian cities, more people are addicted to prescription opiates than street drugs such as heroin or cocaine, according to study published in the April issue of the Canadian Journal of Public Health.

In 2005, the majority of street drug users in main Canadian cities were non-medical users of prescription opioids, with the exception of Vancouver and Montreal, researchers found.

The study's authors estimated that there are between 321,000 and 914,000 people in Canada who are abusing prescription opioids — between one per cent and three per cent of the country's population. ...more

Pharmacist freed on bail

This isn't exactly a positive pharmacist story, but I will try to follow it over the next while. However, with a publication ban in place, it's hard to know how much we will really be able to find out.

From the London (Ont.) Free Press:
London pharmacist charged with illegally selling pain medication was released on bail yesterday.

Gregory Melville, 44, was released on $5,000 no-deposit bail, with his wife acting as surety.

A publication ban was imposed on evidence in the case. ...more

London pharmacist charged with drug trafficking

From the London (Ont.) Free Press:
A London pharmacist has been charged with trafficking oxycodone after his pharmacy was raided this week, police reported today.

Greg Melville, the owner of Forest City Pharmacy at the corner of Wharncliffe and Belmont roads, was charged with four counts of trafficking in oxycodone and two counts of possession of proceeds of crime, one of three people charges after searches of two homes and the pharmacy in London.

That a pharmacist would be charges is unusual, said London Const. Amy Phillipo. “We don’t come across this very often. It’s a rare occurence,” she said.

Abusers of oxycodone crush the tablets to break the time-release coating and then ingest the resulting powder orally, intra-nasally or by injection.

It’s not the first serious allegation against the 44-year-old Mellville — earlier this year, in March, he was accused of professional misconduct in a matter not yet resolved by The Ontario College of Pharmacists. ...more

F.D.A. Weighs Training to Dispense Narcotics

I can`t imagine this ever happening, but it`s an interesting idea...

From the New York Times:
Should doctors be required to undergo special education in order to prescribe powerful narcotics? The Food and Drug Administration may soon recommend that they do so, though such a move would most likely prove controversial.

“I think it is a good idea, and it is something we are considering,” said Dr. Bob Rappaport, the director of the division of Anesthesia, Analgesia and Rheumatology Products at the F.D.A. But the agency itself does not have the authority to take such a step, Dr. Rappaport said.

Typically, state medical boards, rather than the federal government, impose licensing requirements on doctors, including the type of continuing education they must receive. A few states, including California, now provide doctors with education about the treatment of pain patients. But nationally, state medical boards have shown little interest in mandating added training in the use of potent pain medications or in screening patients for those prone to drug abuse.

Pain experts say they support increased education for doctors, but some fear that mandatory training may harm pain patients by limiting the number of doctors prescribing such drugs. ...more

Pharmaceutical drugs overshadowing heroin

From the National Post:
Heroin is fast being replaced by legal pharmaceutical drugs such as OxyContin and morphine among street users of opioids, suggests a national survey of addicts that underscores the challenges and opportunities of the changing drug trade.

Users of pharmaceutical opioids are less likely to inject their narcotics, which is good for curbing infectious disease, but they are also more likely to mix them dangerously with cocaine, crack and other street drugs, the newly published study indicates.

Meanwhile, experts are struggling to understand a supply system that includes retirees peddling painkiller prescriptions and pharmaceutical company employees selling purloined stock. With Canada one of the world's biggest medical consumers of opioids, which provide users with an anesthetizing release, the abundance of legal supplies has undoubtedly fed the illicit street market, researchers say.

There is an "urgent need" to more closely investigate and comprehend the new opioid scene, says the study published this month in the journal Drug and Alcohol Review by researchers in B.C. and Toronto. ...more

Painkiller use stokes death fears

While I agree that work needs to be done to prevent prescription narcotic abuse, I really hope this won't be at the expense of those who genuinely need these medications. I've seen people with abuse problems, but I've also seen a lot of patients who had poorly managed pain control.

From the National Post:
When it comes to consuming prescription opioids, Canadians are world leaders, taking twice as many of the powerful, addictive narcotics as Europeans and 20 times as many as the Japanese.

With some experts afraid the trend could also be exacting a rising death toll, Health Canada is moving to find out how many people succumb to fatal overdoses from the drugs, usually after the pills have ended up on the black market. Evidence from the United States -- one of only two countries that ingest more opioids such as Oxycontin and fentanyl than Canada -- suggests the numbers could be soaring.

Health Canada is hiring outside researchers to come up with a system for tracking the deaths. The results should help decide whether Canadian doctors' propensity for handing out the medicines is justified or not, said one of the addiction scientists commissioned to do the work.

"Part of the assessment of the pluses and minuses is that you have to know how many people die of this," said Dr. Jurgen Rehm, a drug policy expert at Ontario's Centre for Addiction and Mental Health. "No matter what opinion you have on the burning drug questions of the day, you need those data…. It's irrational not to have them."

One pain specialist, though, warns against using overdose statistics to curb legitimate use of the drugs since, if anything, they are not prescribed widely enough now for Canadians with genuine pain problems. Painkiller use stokes death fears

Rules set to loosen for issuing narcotics

The proposed legislation in this article could potentially allow a wide range of health professionals to prescribe controlled drugs. This list could include pharmacists.

For example, in Alberta, the new pharmacist prescribing rules prohibit controlled drug precribing because it's federally regulated. However, these changes would allow a profession to go Health Canada, prove it has the necessary training and then Health Canada would sign off on the profession in a general sense. Then the individual provinces would have to decide whether they would allow narcotics to be included in the scope of other pharmacist prescribing.

Not being able to prescribe these drugs was never a dealbreaker for Alberta pharmacists when it came to pharmacist prescribing, so it may not be necessary to do right away, but it does at least open that door.

From the National Post:
Foot doctors, midwives and nurses would be able to prescribe morphine, Oxycontin and other powerfully addictive medicine under a proposed federal rule that some analysts fear could inadvertently fuel Canada's growing prescription drug-abuse problem.

Health professionals who stand to benefit from a loosening of the decades-old restrictions on "controlled substances" applauded the move. It should mean better service for patients and less strain on the overworked physicians who must prescribe the medications now, they said.

One drug-abuse expert, though, warns that the monitoring and control of opiates is already inadequate, so allowing additional professionals to approve them would shift more pills into the burgeoning black market.

It probably makes sense to give the three groups such prescribing authority, said Dr. Benedikt Fischer of the Centre for Addictions Research of B.C.

However, with Canada using five times as many opiates per capita as the U.K., we need tighter limits generally on the distribution of narcotics, he said. ...more

Protect medication like cash, says N.B. pharmacist

From CBC News:
People who take prescribed painkillers have to be careful not to draw attention to the drugs they are taking, a Sackville pharmacy owner said Wednesday.

George Murray, who is a past president of the Canadian Pharmacists Association, was reacting to an incident Monday in which a customer at Lawton's Drug Store on Elmwood Drive in Moncton was assaulted and had his narcotics stolen at gunpoint outside the pharmacy.

Murray said a person should take the same precautions with drugs as are followed when visiting a bank or using an automatic teller. ...more