PRESCRIPTIONS BECOMING ILLICIT DRUGS OF CHOICE

Overtaking Heroin In Some Cities

TORONTO -- Heroin is no longer the drug of choice among many
substance abusers in Canada, with prescription narcotics such as
morphine and OxyContin now taking its place, says a study of street
users in seven cities across the country.

Researchers found that heroin remains the No. 1 illicit drug only in
Vancouver and Montreal. In the five other cities -- Edmonton,
Toronto, Quebec City, Fredericton and Saint John, N.B. -- more often
than not, getting high means grinding up and injecting prescription opioids.

Furthermore, the switch to highly addictive prescription narcotics
among street users likely represents just the tip of the iceberg,
said lead author Benedikt Fischer, an addiction researcher at the
University of Victoria. If the general population were factored in,
he suspects the numbers would be much higher.

"We have to and will do research in Canada as to what is the shape
and size of the iceberg below the tip that we've been showing with
our little paper," he said Monday. "There are indications that it
might be quite enormous."

"But its potential in terms of size and implications is of a nature
that we better look at it and start thinking about what do we really
need to do about it."

The study, published in Tuesday's issue of the Canadian Medical
Association Journal, showed that heroin in 2005 wasn't even a factor
among injection drug abusers in Fredericton, and it was barely
noticeable in Edmonton and Quebec City. "So that was quite a shocking
finding for us," said Fischer, who also works at the Centre for
Addiction and Mental Health in Toronto. "The dramatic changes are
really what's happening around the opioids."

"This study for the first time systematically documents this for
street-drug-use populations across Canada," he said of the research,
which compares drug favourites among street users in 2001 and again
in 2005. "This is the first research that shows this trend, or the
real picture, across Canada."

While heroin is produced in countries like Afghanistan and typically
imported and distributed by organized crime organizations, which are
subject to prosecution, "opioids come in some fashion directly or
indirectly from a doctor's office, they're produced legitimately by
pharmaceutical companies," he said.

"So we have very different problems here in terms of supply."

Supplying addicts with such narcotic painkillers as Demerol,
Dilaudid, OxyContin and Percodan has given rise to break-ins at
doctors' offices and pharmacies, double-doctoring (seeking
prescriptions from different doctors) and more generalized theft to
turn proceeds of crime into money for drugs.

"The main source is diversion," explained Fischer, so that drugs
intended for legitimate use in people with severe pain, such as
terminal cancer patients, are diverted to those merely seeking to get high.

Diversion is relatively easy in Canada, compared to many other
countries, he noted. While most provinces have some sort of
prescription-monitoring database so doctors and pharmacies can check
an individual's drug purchases, most are incomplete or not equally
accessible by health professionals. There is no national database.

As well, Canada "is a very prescription-happy society," Fischer said.
"Canada is among the top consumers of prescription opioids." But
strictly controlling opioids or curtailing them completely to avoid
illicit use is not the answer, he said, since many people suffering
from pain have legitimate need of the drugs.