'HILLBILLY HEROIN' DEMANDS CONTROLS

The following editorial is reprinted from the Edmonton Journal.

The powerful narcotic oxycodone has spawned a drug abuse problem in many
provinces, but nowhere are its ill effects being felt more strongly than in
Atlantic Canada. Health-care professionals there are right to call for a
tracking system for potentially addictive drugs, much like we have had here
in Alberta for almost 20 years.

Oxycodone, and its most powerful formulation, OxyContin, are among the drugs
covered by Alberta's triplicate prescription program, which logs the doctors
who prescribe certain drugs and the patients who receive them. The idea is
to pinpoint which doctors, if any, are over-prescribing drugs and which
patients are receiving significant amounts, sometimes from a series of
different doctors.

Similar systems exist in B.C. and Saskatchewan, but not in Atlantic Canada.
In the wake of widespread reports of oxycodone abuse, particularly in
Newfoundland and Cape Breton, Health Canada is now asking pharmacists in the
Atlantic provinces to turn over all the prescriptions for OxyContin they've
filled this year in an effort to track the problem.

That is not to say Alberta has not also seen a rise in the use and abuse of
this particularly powerful painkiller, particularly in the southern part of
the province.

Even in Edmonton, officials at the medical examiner's office have seen a
huge increase in the number of people who have had toxic concentrations of
oxycodone in their system when they died, according to Dr. Graham Jones, the
office's chief toxicologist. A decade ago, it was unusual to see even a
single case in which oxycodone was a factor, Jones says. Now, he sees dozens
a year.

Oxycodone has been available for many years, but it wasn't until 1995 that
OxyContin was introduced, a time-release version of the painkiller designed
to work for 12 hours. Doctors prescribe it for people with severe and/or
chronic pain, often related to cancer or other terminal illnesses.

It is also highly addictive, making its potential for abuse akin to that of
morphine. It has been called "hillbilly heroin" because it first became
popular as a street drug in poorer rural areas of the U.S., often where the
heroin trade had not reached. People crush it and inhale or inject it for a
particularly powerful high. In the U.S. it is estimated more than 300 people
have died of OxyContin overdoses in the past two years. In 2000, Oxycontin
was the number-one selling brand-name prescription painkiller in the U.S.,
with sales exceeding $1 billion. In Canada last year, there were 605,000
prescriptions written for OxyContin.

Part of the reason for its popularity is the move by doctors, quite rightly,
to more aggressively treat severe and chronic pain, says Jones. OxyContin is
very effective in reducing pain and enhancing the quality of life for those
who require it for legitimate medical treatment.

But its growing availability by prescription also increases its potential
for abuse. That is not to say the drug should not be available, but rather,
that its use be carefully tracked to minimize abuse.

An 80-milligram tablet of OxyContin sells on the streets of Calgary for $20
to $25, according to the Alberta College of Physicians and Surgeons' most
recent newsletter. In outlying areas, the price can run up to $50.

More than 70 per cent of patients in methadone programs in Red Deer and
Calgary reported abusing large amounts of oxycodone before treatment, says
the newsletter.

But the triplicate prescription program, along with education programs for
doctors and pharmacists and support from substance abuse programs, has
likely helped mitigate the problem here.

In Ontario, where no formal system exists to track prescriptions, sales of
OxyContin have increased 600 per cent in the past four years. The province's
coroner has attributed at least 250 overdose deaths in the past six years to
the drug.

No drug-tracking system is foolproof, and some abuse of powerful, addictive
drugs is inevitable. Everyone from street people to Hollywood stars has
become addicted to oxycodone. But careful monitoring across the provinces,
coupled with education and strong support programs, can certainly help
control the problem.