Ontario will stop paying for higher-strength opioid medications through its Ontario Drug Benefit (ODB) program next January as part of its strategy to address the growing problem of addiction to the painkillers.
Opioids such as fentanyl and morphine are often prescribed to patients with chronic pain, but can often lead to addiction and overdose deaths.
To help fight what it calls the "growing problem of opioid addiction in Ontario," the province's Ministry of Health and Long-Term Care announced last week that it would stop paying for the following higher-strength long-acting opioids from its ODB drug formulary as of January 2017:
- Morphine, 200 mg tablets.
- Hydromorphone, 24 mg and 30 mg capsules.
- Fentanyl, 75 mcg/hr and 100 mcg/hr patches.
The province will also delist 50 mg tablets of Meperidine, also known as Demerol.
The ministry said it was giving six months notice of the funding changes to give patients time to consult with their doctors about changes that may be required to their drug treatment plan.
"Physicians should initiate this discussion as soon as possible with any patients affected by these changes," the ministry advises in a notice on its website.
Ontario's drug benefit plan pays the cost of many prescription drugs for those 65 and over as well as for those on assistance.
Lower doses better for patients
The Ontario government's action followed its establishment of a "pain subcommittee" to carry out a review of narcotics prescribed for pain management.
"The subcommittee indicated that lower opioid doses may improve patient outcomes," the ministry said in a statement. "Since many patients on high doses may be considered 'opioid failures,' tapering or withdrawing opioid treatment may result in improved mood, pain and function, with less sedation, fatigue, constipation, etc."
Deaths linked to opioid use in Canada have soared in recent years.
A 2014 study found that opioids were related to one in eight deaths among young people in Ontario.
Rates of opioid-related death in the province increased by 242 per cent between 1991 and 2010, rising from 12.2 deaths per million in 1991 (127 deaths annually) to 41.6 deaths per million in 2010 (550 deaths annually).
More recently, British Columbia declared a public health emergency in April after a dramatic increase in the number of overdose deaths from opioids like fentanyl.
Of the 201 overdose deaths recorded in B.C. in the first three months of 2016, 64 involved fentanyl, according to the province's medical officer of health.