The province's health minister says he stands with Ottawa in more clearly labelling the health risks of “hillbilly heroin,” as painkillers such as generic OxyContin are sometimes called, to help stem the abuse of drugs that are causing rising numbers of overdoses and deaths among Ontarians.
"My ministry is supportive of efforts that help promote the appropriate use of narcotics and controlled substances, including Health Canada’s recent labelling changes for controlled-release opioid pain medications," said a statement from Health Minister Eric Hoskins.
On Monday, Health Canada advised it is toughening up warning language on all controlled- and extended-release non-generic opioid labels, such as those on products similar to OxyContin, although that brand is no longer available in Canada. Effective immediately, existing warnings and safety information, such as the health impacts and addictive properties of the opioids, will be made clearer. So too will the risks to children who ingest the drugs, or to newborns who are exposed to the painkillers during pregnancy.
Approved use of the painkillers in that class would be hiked up as well, removing their use for “moderate” pain.
“The new label clarifies that these drugs are indicated for the management of pain severe enough to require daily, continuous, long-term opioid treatment that is opioid-responsive and for which alternative treatment options are not adequate,” states Health Canada’s advisory. The change would allow for continued prescription, it says, but give the prescriber an obvious reminder of the painkillers’ pitfalls.
“The updated guidance also encourages more appropriate patient selection and monitoring,” adds the statement
Health Canada said the same label changes would be coming shortly for all generic opioids.
The feds want to curb addiction and abuse of the painkillers, as the drugs have, “serious negative health impacts, even at recommended doses.” Accidental overdoses and death can be caused by overuse of the controlled-release painkillers, which are designed to be long-acting and steadily-absorbed by the body, allowing the patient to taper off their use.
Abuse of OxyContin, its derivatives and codeine has become much more widespread in North America in recent years.
In Ontario, studies have found rising numbers of annual opioid-related deaths. A report done in July by researchers at St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences discovered deaths tied to abuse of the painkillers in the province quadrupled to 550 in 2010 from 127 in 1991. One in every 170 deaths in Ontario may be related to opioid overdoses, said the study’s lead author.
By Health Canada’s count, there are currently 38 brand-name and generic controlled-release opioid medicines in the country. They include versions of the drugs morphine, oxycodone and fentanyl.
Hoskins said the province is also supportive of Health Canada's consultation process, which is weighing whether to change the Controlled Drugs and Substances Act to require all drugs at high risk for abuse, like controlled-release oxycodone, to be tamper-resistant before being sold in Canada.
The health minister added the provincial government has identified the abuse of prescription narcotics as a "public health concern," and has increased money going to mental health and addiction services by $506 million. At the same time, the minister said the government has brought in measures like the Narcotics Monitoring System (NMS) to track where controlled substances are being dispensed.
In response to increased abuse, Ontario has also changed its criteria for funding long-acting opioids under its drug plans – forcing manufacturers to, among other things, prove the drugs cannot be crushed up for snorting if they want to be publicly funded, like OxyContin offshoot OxyNeo. Generic forms of oxycodone can be prescribed in the province, but they are only supposed to be made available if they meet certain criteria.
Former health minister Deb Matthews, before becoming Treasury Board president, campaigned against allowing the sale of generic forms of OxyContin, but then-federal health minister Leona Aglukkaq said she could not interfere Health Canada's approval process.
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Health minister happy painkillers getting harsher labels

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