Fight the deadly opioid epidemic at its roots

Our narcotic abuse and death rates are likely at their highest in modern history

Alan Cassels

VICTORIA, B.C. / Troy Media/ – We are in the midst of a deadly drug epidemic so severe and widespread that few people in North America will remain untouched by it. A dramatic change in how physicians are trained is required to get the epidemic under control.

Our narcotic abuse and death rates are likely at their highest in modern history.

Critics have begun pointing the finger at the medical system and its prescribers – well-meaning doctors and specialists who’ve been giving too many patients excessively powerful opioid medications to deal with modest pain. But we should dig deeper and look at the relationship between the medical education system and pharmaceutical companies.

Recently, Dr. Perry Kendall, British Columbia’s provincial health officer, said that his province has a bona fide “public health emergency” on its hands, mostly due to the alarming number of overdose deaths linked to prescription opioids.

Opioids include prescription narcotics like oxycontin, hydromorph contin and fentanyl (which some say is 100 times stronger than morphine). Kendall said that there have been more than 200 opioid-related overdoses so far this year in B.C., and if those numbers continue, there’ll be 800 by the end of the year.

What’s happening in B.C. is just a microcosm of what is happening across Canada, where we have some of the highest rates of prescription opioid consumption in the world. From 2006 to 2011, use of opioids in Canada rose by 32 per cent and that rise has continued unabated, despite efforts to slow it down.

The problems, as well as potential solutions, are incredibly complicated but curbing society’s exposure to opioids – particularly those that come from a prescription pad in a doctor’s office – is absolutely vital.

The liberal prescribing of opioids is a recent problem and, since the mid-1990s, can be linked to the message-crafting activities of the pharmaceutical industry. That industry helped shape both patient perceptions of pain and how doctors thought about the safety of these drugs. Doctors were increasingly encouraged – sometimes through industry-funded educational activities or by using textbooks on pain management paid for by the makers of opioids – to prescribe the drugs for a much wider population of patients experiencing pain.

If revising the messaging around opioids was a business-oriented strategy by the opioid makers, we cannot place the blame solely upon them. Some of that blame has to do with the co-dependent relationship between physician education and the drug industry, which funds a substantial portion of physician education in Canada.

Tackling the addiction problem requires serious, multifaceted source control. We need greater access to addiction treatment facilities and methods to rescue people from the depths of addiction, certainly. But we also need to curb society’s underlying dependence on drug company money for doctor training.

– Alan Cassels is an expert advisor with EvidenceNetwork.ca and the author of the just-published The Cochrane Collaboration: Medicine’s Best-Kept Secret.