Concern that generic replacements for OxyContin could lead to a dangerous increase in drug addictions and overdoses has not led the federal government to intervene in their possible release later this month.
Health Minister Leona Aglukkaq announced that the government would not stop the release of generic OxyContin — a pain reliever that was removed from the market because it was being abused by drug users.
Some may find it morbidly ironic that the announcement came on the first day of National Addiction Awareness Week.
Via the Canadian Press, Aglukkaq said federal laws do not let regulators ban a drug because it could be abused, adding it will be up to the provinces to ensure the generic drugs are not over prescribed by doctors and pharmacists.
This comes after the provinces unanimously requested Aglukkaq delay the approval process for the generic replacement over concerns that, like its predecessor, it could lead to drug abuse, addiction and death.
The quick history lesson on Oxy is that, when used properly, it relieves pain over the course of 12 hours... and everything is wonderful in the world.
But the easily-abused drug became popular on the streets. By crushing or chewing the drug, users could release all of the pill's effects at once and create a heroin-like high.
Purdue Pharma pulled OxyContin from the market and replaced it with OxyNEO, which is said to be harder to abuse.
But when OxyContin's patent expires on Nov. 25, generic drug makers will have free reign to seek approval, which doctors fear could open the flood gates again.
In a blog post on Monday, Dr. Brian Goldman, host of CBC Radio's White Coat, Black Art, urged against the release of generic OxyContin:
Make no mistake. Ending the sale of OxyContin created all kinds of chaos. Without adequate places in addiction treatment programs, many drug abusers have frequented emergency departments and clinics — not to mention the street — in search of a substitute fix. Legitimate pain sufferers had to be transitioned to OxyNeo or some other opioid analgesic.
But the removal of OxyContin was like drawing a line in the sand in the desert of opioid drug abuse. Now, the stage has been set for an egg painfully unscrambled to be scrambled again.
Mixed metaphors aside, Goldman urges the federal government to play a proactive role and tighten licensing rules ahead of the generic drug's release to ensure there won't be a mess to clean up later.
The concern isn't just that drug abusers will get their hands on the pills again, but also that those who are prescribed the drug to combat chronic pain will become addicted.
Drs. Irfan Dhalla and David Juurlink made that point in an article for the Ottawa Citizen, describing Aglukkaq's announcement as the latest development in "a public health crisis."
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The pair, noted physicians and researchers, says overdose deaths involving prescription medication are responsible for more than 100,000 deaths across North America in the past 20 years. They urge the federal government take steps to ensure opioids are difficult to tamper with.
All opioids — not just OxyContin — can be misused, and the federal health minister is correct when she says that the law does not permit her to withhold approval of a generic formulation just because of the risk of misuse. But when the legal and regulatory framework results in a situation in which more than a dozen Canadians die each week because of an accidental prescription drug overdose, that framework needs to be changed.
Avoiding a problem isn't as simple as having the federal government block the release of generic drugs, but the problem also can't be fixed by throwing it on the shoulders of provinces and doctors.
Aglukkaq says she would consider new regulations if the problem gets out of control. Why not take the advice of those in the know and consider it now?