Our town hall entitled "Generation Rx -- The Use and Abuse of Prescription Pain Medication" is just three days away. According to the Ministry of Health and Long Term Care, in Ontario alone, prescriptions for medications containing Oxycodone paid for on the province's Drug Benefit Program have risen nine hundred percent since 1991. Along with the increase in prescriptions has been a disturbing trend: Between 1991 and 2007, deaths related to all opioid painkillers in Ontario nearly doubled - and deaths related to oxycodone - the active ingredient found in OxyContin - went up five-fold.
Unfortunately, much of the blame for the problem rests with inappropriate and in some cases unnecessary prescribing by physicians, dentists and other health care providers. At the town hall, Dr. Andrea Furlan, an expert in chronic pain who spearheaded the development of safe prescribing guidelines for physicians, put much of the blame on lack of education in medical and dental school.
"There's very little education in medical schools and residency programs," Furlan said at the town hall held last week at Brockville Collegiate Institute in Brockville, Ontario. "And, unfortunately, when the physician goes to practice, they get their education from drug representatives who knock on their door, and come with nice documents (and) colourful brochures, teaching them how to prescribe these medications."
We received an email from a listener named Ada Guidice-Tompson, who writes: "I am a bereaved mother who lost my only child Michael to an opioid prescribed by his doctor. I am now Vice-President of Advocates for the Reform of Prescription Opioids.
According to the web site, Advocates is a group of citizens, "who have, in one way or another, been affected by a major change in the medical practice of prescribing opioids (narcotics) for pain."
"Although several factors have given rise to the prescription opioid epidemic, one clearly stands out -- physicians relying on pharmaceutical reps as their source of education," says Guidice-Tompson.
"This education is fraught with inherent bias, conflict of interest and ongoing deceptive marketing practices."
One way of counteracting the bias is to provide credible information from sources that aren't tied to pharma. One such source is a web site called Physicians for Responsible Opioid Prescribing, The group's mission is to "reduce morbidity and mortality resulting from prescribing of opioids and to promote cautious, safe and responsible opioid prescribing practices."
Among the stellar group of experts that make up the organization's board is Dr. Irfan Dhalla, a physician at St. Michael's Hospital in Toronto. Dr. Dhalla has worked tirelessly to raise issues of opioid abuse while promoting responsible prescribing. He has authored many articles on the subject, including this commentary published in the British Medical Journal.
Pain management would be a lot safer if doctors checked out these resources. Don't wait for your doctor to do so. Check them out yourself.
And don't forget to listen to Generation Rx this Saturday December 3 at 11:30 am (noon NT) and again on Monday December 5 at 11:30 am (3:30 pm NT) on CBC Radio One.