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The Canadian Centre on Substance Abuse (CCSA) has unveiled a 10-year national strategy aimed at tackling Canada’s growing crisis of prescription drug abuse.
The comprehensive plan defines the scope of the problem and calls for action in 5 critical streams—prevention, education, treatment, monitoring and surveillance, and enforcement. Implementing the recommendations will require a commitment from governments, health professionals, addiction specialists and consumers—and pharmacists will be key participants, according to the pharmacy representative on the advisory council that helped develop the plan.
The plan entitled First Do No Harm: Responding to Canada’s Prescription Drug Crisis was unveiled March 27, 2013, at an Ottawa news conference that included the chief executive officer of the CCSA, Michel Perron, and the federal minister of health, Leona Aglukkaq.
“Harms such as addiction, overdose and death associated with certain prescription drugs—opioids, sedatives and tranquilizers and stimulants—are a leading public health and safety concern in Canada that has now reached crisis proportions,” Mr. Perron said at the news conference.
According to the First Do No Harm report, Canada now ranks as the world’s second-largest per capita consumer of prescription opioids, behind only the United States. Canada’s rate of use increased by 203% between 2000 and 2010, an increase steeper than in the US. The goal, says the report, is to ensure that these medications are used appropriately to provide much-needed benefits while minimizing the escalating harms.
“The more I learned, the more surprised I was at just how extensive these problems have become,” says Debbie McCulloch, vice-president and Saskatchewan representative with the National Association of Pharmacy Regulatory Authorities (NAPRA). Ms. McCulloch is a pharmacist in Rosetown, Saskatchewan, and she represented pharmacy on the National Advisory Council on Prescription Drug Misuse—a group assembled to work on the strategy.
“The seriousness of this issue—I think this is part of the message that we as pharmacists have to give the public,” she adds. “And we can play a significant role in prevention and education in our communities. A lot of it is one-to-one with patients, telling people about the signs and symptoms of misuse and about safe storage of prescription medications, but it’s also doing more ‘social marketing’ by educating people at events, health fairs and through media, the way we often do on issues such as diabetes.”
Among the recommendations are a call for a standardized pan-Canadian surveillance system that tracks the nature and extent of the harms associated with prescription drugs and for all provinces and territories to establish prescription monitoring programs within the next 2 years.
The strategy also recommends promotion of appropriate prescribing and dispensing practices among health care practitioners and expanded access to a range of effective treatment options for pain and addictions.
“In terms of prescribing, we can act as gatekeepers,” says Ms. McCulloch. “We already do that but that role can grow, so that we more frequently reinforce the risks with patients and in communication with the physicians who are prescribing opioids and other potentially harmful drugs.”
Only some provinces in Canada currently have extensive prescription drug monitoring programs. They include British Columbia, Alberta, Saskatchewan and Nova Scotia; Ontario recently introduced its own drug monitoring database.
The system in Saskatchewan is very comprehensive and that model could be useful in other jurisdictions, says Ms. McCulloch. A consultant pharmacist works with the Prescription Review Program at the College of Physicians and Surgeons of Saskatchewan to help identify potential addicts and warn physicians about patients at high risk.