DANGER IN A BOTTLE

Somehow, a drug looks less threatening when it's in a white bottle
with a drugstore label, than when it's being snorted or injected by a
strung-out addict on the street.

But oxycodone is the same substance, whether the pill is swallowed as
directed on those labels, or whether it's crushed into the powder
that addicts use. Oxycodone is an addictive opiate, like heroin. It's
found in prescription painkillers, such as Percocet and OxyContin.
OxyContin pills are formulated to release the dose over about 12
hours, but when the pill is crushed and snorted or injected, the hit
comes faster. And that's dangerous.

The Ontario coroner's office is hoping to examine its potentially
fatal effects soon. The Toronto Star recently reported an estimated
464 people died from oxycodone overdoses in Ontario over the last
five years. Overdoses of this drug account for far more deaths than
heroin, in Ontario, and nearly as many as cocaine.

In contrast, there has never been even a single fatal marijuana
overdose. Yet the global resources put into cannabis eradication are
staggering, and the social stigma, as swimmer Michael Phelps can
attest, is strong.

Oxycodone is a far more serious problem. But what to do about it?

The first step should be to accelerate the province-wide
implementation of e-health records. This would allow pharmacists to
see, at a glance, whether a patient has already filled a prescription
at another pharmacy. It would allow doctors to see, at a glance, how
much time has passed since the patient last received a prescription
for the drug from any Ontario doctor. It would help the health-care
system to identify and treat addicts, to educate them about the risks
of overdose, and to stop unwittingly enabling them by handing out
duplicate or unnecessary prescriptions. Doctors and pharmacists have
a professional obligation to do no harm, and should have all the
information needed to fulfill that obligation.

Still, that wouldn't stop addicts and dealers from seeking the drug.
Pharmacies are already at risk from thieves seeking OxyContin for
their own use or to sell on the streets. (One hapless Ottawa thief
recently made off with 16 bottles of Tylenol 1, after demanding
OxyContin and being told there was none in the store.)

Ultimately, no society can eliminate the demand for drugs by simply
restricting the supply; changes in the availability of any one drug
will only alter patterns of drug use in the market, for good or ill.
The only way to reduce overall demand is to help people make better
choices, and remove, as much as possible, the conditions that tend to
coincide with addiction. OxyContin is a drug of the poor; it's
sometimes called "hillbilly heroin" and addiction to it appears to be
disproportionately high among people on social assistance.

Ontario can also do a better job of providing and encouraging
treatment for oxycodone addiction, which is similar to treatment for
heroin addiction.

It would be foolish to ban oxycodone. It is a useful drug for
patients trying to manage extreme pain. It's never simple or easy to
reduce the damage done by abuse of any drug. It is, however, worth
the effort, whether the pill comes with a drugstore label or not.