Opioid addiction has reached a crisis level in Canada, in part due to prescribing practices and it's going to take a shift in public attitude to get it under control.
That's one of the messages coming out of the Canadian Pharmacists Association conference Sunday in Calgary, where pharmacists are learning about the dangers of over-prescribing.
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Newfoundland-based pharmacist Keith Bailey says we need to have a national conversation about opioids.
"We're at a crisis level in this country in terms of overuse. And I think, to be honest, all of us in health care are part of the issue," said Bailey, who has been a pharmacist for 21 years.
"We need to collectively work to help solve that problem. Better prescribing standards, better patient support, better education," he said.
"We have to admit there is an issue as a society broader than just health care and we have to deal with this issue."
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Bailey sat in on a session with David Juurlink, a drug safety researcher at the University of Toronto.
Juurlink says as recently as the early 90s it was uncommon for doctors to prescribe opioids for chronic pain, but by the middle of the decade, doctors were prescribing drugs like Oxycontin.
"Doctors see pain all of the time and we are conditioned by nature to want to treat it. We live in a society where pills are very often a part of how we treat things," Juurlink said.
"We were told that these drugs could work well, they were safe, they didn't trigger addiction and they would go on working. We happily took that message, we deployed these drugs like mad and we now in hindsight realize how big a mistake that was."
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He said that push, in part, came from patients and pain advocacy groups with ties to drug makers.
Over the years tolerance has gone up, and some people have progressed to powerful drugs like fentanyl, which killed almost 300 people in Alberta last year.
"That's a direct response to the fact that we've created a market for opioids. Whether it's the patient who was started on opioids for a broken ankle and just never came off them and became addicted, as patients sometimes do. Or whether it's the 19-year-old who got some pills at a party or in his parents medicine cabinet and became addicted that way."
Juurlink says going forward, health care workers need to think twice before prescribing opioids to people who have never used them.