PRESCRIPTION DRUG ABUSE SKYROCKETS IN WINDSOR AREA

WINDSOR, Ont. -- The number of people seeking treatment in Windsor for
addiction to prescription drugs is more than five times the provincial
average and the number for women is even higher, experts in the field
say.

Seven hundred and twentysix of the 1,650 people entering the local
detox centre as they went through withdrawal in 2009 listed
prescription opioids as one of their primary substances, compared to
527 of the 1,599 entering detox two years earlier.

Alcohol is "not the big one anymore," said CAW Local 444 employee
assistance program rep Bruce Malcolm, who sends Chrysler workers for
treatment. "Most of them are Oxy-Contin or Percoset."

These are regular folks, most of whom have not had addiction problems
in the past. But they get an injury, or surgery, or suffer some sort
of chronic pain, and painkillers are prescribed.

"And unfortunately before they know it they start missing time and
they start misappropriating the dosages. And before you know it
they're buying them elsewhere," Malcolm said.

Drug addiction among women in Windsor has reached "epidemic" levels
and the wait for help is at least six months, according to the
operator of a women's treatment centre.

"We have an epidemic of women who are hooked on narcotic pain
relievers; it's overwhelming us," said Deborah Gatenby, executive
director of the House of Sophrosyne, a women's addiction treatment
centre.

Provincially, 5.2 per cent of people seeking drug treatment are
addicted to prescription opioids. But locally, in the region covered
by the local health integration network, 27.8 per cent of people and
39 per cent of women seeking treatment are hooked on prescription
opioids, which is eight times the provincial average, Gatenby said.

A U.S. study showed that 85 per cent of women and 79 per cent of men
entering treatment for opioid addiction were first exposed to them
through a prescription to treat pain.

Pat Keenan, who was the Local 444 EAP rep before retiring two years
ago, watched OxyContin use steadily grow. "From occasionally to just
about the everyday drug of choice for everybody."

The reason is fairly simple: "You can get scripts, and when you can't
get scripts you can buy them off the street."

Percosets sell on the street for $3 or $4 for a five-milligram dose. A
10-milligram dose of OxyContin sells for $5, while 20-milligram doses
sell for $8 to $10. Stronger doses of 40 milligrams sell for $12 to
$15 and the 80 milligram pills sell for $35.

A recent study showed prescriptions for oxycodone -the drug in both
OxyContin and Percoset -rose 900 per cent from 1991 to 2010 in
Ontario. One of the reasons is there's nothing preventing someone in
Ontario from going to many different doctors and getting multiple
prescriptions.

Ontario Health Minister Deb Matthews is worried about what's
happening. "We have a major problem on our hands in Ontario," she says
of the rapidly rising use -and misuse -of prescription
painkillers.

She's hoping recently passed legislation allowing the government to
track the prescribing patterns of patients, doctors and pharmacies
will help prevent people from double doctoring, getting
inappropriately high dosages or getting refills too frequently. She
hopes it will be up and running some time this year.

"For physicians who don't know their patients really well, it will be
a really, really useful tool," she said.

"It will allow doctors to know, before they prescribe, whether a
patient has had a recent prescription from another physician."

Matthews said she had her eyes open to the rising use of prescription
narcotics when she went on a ride-along in her hometown of London with
an officer who worked with sex trade workers. "What I learned ... was
that virtually all the women working in the sex trade on the street
were addicted, and many were addicted to prescription narcotics."

Hotel-Dieu Grace emergency medical director Dr. Gord Vail has been
involved in confrontations with patients desperately seeking narcotics.

"Lots of people come in and say 'I've lost my script, it's flushed
down the toilet, my landlord took it, I had to move and the movers
lost it.' We get every sob story you can think of."

Vail said patients resorting to the already overloaded ERs for
painkillers is becoming a bigger problem because of the shortage of
family doctors who can adequately monitor patients suffering chronic
pain, prescribe refills and make adjustments in dosage and drug that
are appropriate. That leaves people to either go to walk-in clinics,
most of which refuse to refill narcotics because they don't know the
patient, or go to the ERs.

"It puts us in a hard place to make that decision," said Vail, who is
also his hospital's chief of staff. "They come in and say they're on
OxyContin at some ridiculously high dosage and it's up to us to decide
if that's appropriate or should be continued."

And there's no scan or blood test that can tell you a person's back
pain is so severe he needs a narcotic painkiller.

"So it's up to us to decide is this person being truthful," Vail said.
"Are they in a lot of pain, or is it something they're going to sell
on the street two minutes later?"

Doctors are prescribing powerful and addictive drugs like OxyContin to
treat chronic pain, a condition that only started being recognized
about 15 years ago as a legitimate condition, said Dr. Allan Gordon,
director of the Wasser Pain Management Centre at Mount Sinai Hospital
in Toronto. Currently, between 20 and 30 per cent of the population
has it -back pain, joint pain, fibromyalgia. And alternative
treatments to drugs, such as physical therapy, aren't always easy to
access. So doctors turned to opioids like Percoset and OxyContin. "I
think opioids can be effective and certainly do work," said Gordon.
"But you have to be very cautious with who uses them and what
restraints and boundaries you employ."

Every patient needs a risk assessment, a list of questions on such
issues as family history of addiction that help a doctor gauge the
risk of addiction, he said.

"Not everyone is equal. Ninety per cent of the population, if you give
them this medication there's not going to be a problem. But with 10
per cent there's going to be a problem."

Mellissa, a 27-year-old with two kids and a job as a personal support
worker, was prescribed Percoset for a herniated disc more than five
years ago. When her doctor cut her off, a friend introduced her to
OxyContin. "It started off with just one. They're horrible, they're
the devil, those things," she said. Within a month she was taking
massive quantities -up to 400 milligrams a day. "I could spend
anywhere from $80 to $250 every day," she said, recalling how she'd
pawn possessions and borrowed money to pay for drugs. "Now I look
back, I don't know how I got the money."

She's thankful she got off Oxy by entering a methadone maintenance
program. "It saved my life, because if it wasn't for that I would
probably have lost my children, my job and myself."