Provincial pushback on opioid overdoses and deaths has apparently led to a major drop in prescribing the potentially deadly drugs in Ontario. A new study may include lessons for the United States.
The Canadian province is dealing with the same problems as other governments in North America and trying to find its own solutions. One of the first was putting all records of narcotics prescriptions into a central database and asking the Ontario Drug Policy Research Network to start analyzing that data.
Epidemiologist Tara Gomes said data shows an 18 percent drop in opioid prescription volume between January 2015 and March of this year. Gomes said the province is refusing to pay for the strongest opioids.
"The public drug program in Ontario recently de-listed the high-strength opioids, so these are the highest strength ones - the oxy-neo, the long-acting oxycontin, the hydromorphone and fentanyl - so that they no longer will pay for these higher-dose drugs," Gomes said. "And we have actually seen that that has led to large reductions in dispensing of those high-strength opioids, across the board."
Gomes said the accumulated data also shows who is prescribing large amounts of opioids and where.
"We definitely see hot spots in the province," she said. "So the Hamilton Niagara region, which is just across the border from you, is one hot spot of high-prescribing in the province and, as well, high rates of opioid-related deaths. And then up North in some of rural and remote communities, we also see very high rates of opioid prescribing and addiction."
The data shows one in seven Ontarians was prescribed an opioid last year - or 2 million people - and 85 percent of those patients were prescribed the drug as pain treatment. Gomes said part of the problem is that doctors traditionally have not been trained in prescribing the highly dangerous drugs.
"A lot of those lessons that they did receive on managing pain came directly from pharmaceutical manufacturers," she said, "and so the messages that were used in training in medical schools was that long-lasting opioids were safe and effective to treat pain and were a great tool for a clinician to have when managing pain in their patients."