Pain relievers linked to more deaths: Study
Reported December 08, 2009
OTTAWA Experts call it Canada’s hidden drug problem, one that kills more people than heroin overdoses. The difference? Instead of scoring on the street, you can get it with the flick of doctor’s pen.
Deaths from the misuse of prescription narcotic pain relievers have nearly doubled in 13 years, says a study released Monday.
When mixed with alcohol or prescription sedatives, prescription pain relievers, called opioids, can have fatal effects, say researchers involved in the study published in the Canadian Medical Association Journal.
“This is a prominent, very prevalent problem,” said Benedikt Fischer, a public health professor at Simon Fraser University. “It comes from an unexpected side, namely medications we all think are just therapeutic and safe and wonderful because we get them from the pharmacy and the doctor. But they obviously bear a lot of risks and harms.”
Fischer, who contributed a commentary on the study in the CMAJ, said while data is not available for the entire country, he suspects a surge in opioid-related deaths can be found nationwide.
The study found that opioid-related deaths in Ontario nearly doubled between 1991 and 2004, from about 14 people per million residents in 1991 to 27 per million in 2004.
Prescriptions also soared 850 per cent between 1991 and 2007 a trend that researchers say is directly related to the introduction of a long-lasting form of opioid known as oxycodone.
When oxycodone-type drugs became available publicly in the late 1990s, opioid-related deaths rose by 40 per cent, and oxycodone-related deaths increased more than fivefold. For example, 103 people died from oxycodone in 2003, as compared with 16 in 1999, the study said.
To put the severity of the situation into context, David Juurlink, a doctor from Sunnybrook Health Sciences Centre in Toronto who worked on the study, said that while H1N1 has killed a little over 100 people in Canada, in the last year of the study, opioids were killing about 300 people in Ontario alone.
“This is a major public health issue,” said Juurlink.
Researchers said the study’s findings point to a growing trend among doctors who are prescribing narcotic pain killers, sometimes unaware of the dangers to patients. They asked for an electronic database to track prescriptions in Ontario.
While oxycodone drugs can be effective for chronic pain such as advanced cancer, they have been prescribed more frequently for other problems, such as back pain and arthritis.
“We, in Canada, prescribe or use more prescription opioids than virtually any country in the world, except for the U.S.,” said Fischer.
When one such drug, OxyContin, was introduced to Ontario it was marketed to doctors as a safer, less addictive drug, which the study’s authors said has been proven false. In the U.S., senior executives at the pharmaceutical company Purdue Pharma, which makes the drug, pleaded guilty to deceptive marketing and were ordered to pay fines in excess of $600 million in 2007.
In a written statement, Purdue Pharma Canada in Pickering, Ont., said it was concerned about prescription drug abuse, acknowledging it as a growing health problem.
“Purdue Pharma Canada will continue to do its part to help reduce diversion and abuse of medications, while making sure they remain available for appropriate medical use,” it said.
“It is important to recognize that opioid analgesics have an established medical purpose. OxyContin remains a safe and effective medicine when used appropriately and under the supervision of a physician.
“Purdue Pharma Canada is continuing to provide doctors with the information and tools to help them prescribe opioid analgesics safely when medically appropriate. The marketing of OxyContin has always been conducted in compliance with all Canadian laws and the regulations for the pharmaceutical industry in Canada.”
Irfan Dhalla, a doctor at St. Michael’s Hospital and one of the study’s authors, said it’s not clear whether doctors and patients understand how serious the side effects can be from oxycodone drugs which can be twice as strong as morphine.
“One of our messages to physicians would be: OxyContin is not just another new Tylenol 3,” said Dhalla.
The study’s medical researchers looked at nearly 7,100 files at the Office of the Chief Coroner for Ontario, ranging between 1991 and 2004. They then compared those files with provincial data between 1991 and 2007 from pharmaceutical consulting firm IMS Health Canada, an organization that tracks the sale of provincial drugs.
The coroner found that more than half of the opioid-related deaths in Ontario were unintentional, and another 22 per cent died from undetermined causes. The average age of people who died from opioids was 40 years old. Most had visited a doctor at least once a month before their death.
Source : Canwest News Service