No quick fix to prescription drug abuse
Narcotics - also known as opioid painkillers - are prescribed for people with severe pain. The trouble is, these pills last three or four hours.
Beginning in the late 1980s and early 1990s, drug makers began manufacturing extremely powerful narcotic pills that packed twelve hours worth of narcotic into a single pill. For people with chronic pain, that meant they only had to take a pain pill twice a day. Very quickly, addicts and recreational users discovered that they could tamper with the pill by chewing, crushing or dissolving it, get the entire 12 hours' worth of narcotic at once, and inject, smoke or snort it to get a heroin-like high. That's what made OxyContin or Hillbilly Heroin - one of the most frequent and most deadly drugs of abuse. A decade or so ago, drug makers began working on a type of OxyContin pill that could not be crushed or dissolved. A perfect solution to addicts looking for a high, or so they thought.
Full disclosure: I once had an office practice in which I prescribed narcotics including OxyContin to patients with chronic pain. As I have discussed before on this web site (the archived blog entries no longer go back to 2008) and elsewhere, I also gave lectures and seminars to physicians that were paid for by Purdue Pharma (the maker of OxyContin and more recently OxyNeo) on managing chronic pain.
The commentary in CMAJ - by doctors at Women's College Hospital and the Dalla Lana School of Public Health in Toronto - says that tamper resistant narcotic pills may deter users who are trying to achieve heroin-like high. According to drug makers, tamper resistant pills reduced accidental overdoses among people who crush and inject or smoke the narcotic. Make a drug like OxyContin in tamper-proof pills, and users went looking for other narcotics not made in tamper-proof pills. Since regulators ruled that tamper-resistant pills were new products, drug makers marketed them at a high price that discouraged users from taking them.
The commentary in CMAJ says it's time to stop believing in what it calls 'gimmicks' like tamper proof pills. It calls for a comprehensive population wide strategy to combat prescription drug abuse. That includes preventing the problem by reducing kids' exposure to drugs. It also means early recognition of teens and adults who show early indications of prescription drug abuse through provincial programs that monitor the prescribing of narcotics. It also means better access to effective addiction treatment programs. All that costs a lot of money. Still, the cost of prescription drug abuse and overdoses is almost incalculable.