Ontario-based company Purdue Pharma will introduce OxyNEO as a replacement for the currently available formulation in an attempt to inhibit abuse of the narcotic. While the dosage and ingredients of the two drugs in the opioid family are the same, the new formulation is harder to crush into powder or turn into liquid, which prevents people from achieving the intense euphoric feeling derived from snorting or injecting oxycodone.
According to a report published early this year the official publication of the College of Family Doctors by U of T Professor David Juurlink and his colleagues the mortality rate among patients prescribed opioids, such as oxycodone, for non-cancer pain is roughly 5 times higher than in patients who are not prescribed this type of narcotic.
Though Ontario, along with Saskatchawan and the Atlantic provinces, has announced that both OxyContin and OxyNEO will no longer be funded publicly, after February 28, doctors may deem patients eligible for the latter through the Exceptional Access Program.
While the provincial government’s decision may prohibit certain illegitimate uses of the specific brand of oxycodone, deterring narcotic use may not be that simple, due to the highly addictive nature and accessibility of the drugs in the opioid family.
“Crushers will have other alternatives, as there are other drugs on the market,” said Juurlink, who is also the head of the Division of Clinical Pharmacology and Toxicology at Sunnybrook Health Sciences Centre. Juurlink explained that a dramatic decrease in legitimate or illegitimate narcotic use and consequently, a mass withdrawal from the drug, is unlikely.
According to the province’s 2010 report on Narcotics Strategy, Ontario has the highest rate of narcotics use in Canada, and the number of oxycodone prescriptions has risen by 900 per cent over the last two decades.
Juurlink attributes the steep increase in oxycodone use to a number of reasons, but cites the liberal prescription of the drug by doctors to be a significant factor. “The chemical in oxycodone isn’t inherently more prone to abuse than other opioids, but doctors have become comfortable in prescribing it in very high doses.”
As pharmaceutical companies are not legally allowed to market the health claims of their products directly to consumers in Canada, they must appeal to physicians to support and prescribe them as they see fit. Despite the lack of comprehensive data to support the safety of prescribing opioids as painkillers, Juurlink explained, the rewarding response to this type of drug in the way of pain relief is appealing to doctors who aim to reduce or eliminate their patients’ severe discomfort.
Juurlink sees the solution to high rates of narcotic use in a concerted effort between doctors, pharmaceutical companies and the government. He cited the database used by B.C. since 1995 that monitors each prescription doctors issue, which deters prescription fraud and prevents against potentially harmful interactions between medications. “The provinces should be making it a huge priority to track who is getting what, when, where, and from whom.” The Ontario Narcotics Strategy proposed the development of a database to monitor prescriptions in August 2011, but the province has yet to confirm its development.
OxyContin will be available in Ontario until April 2 of this year or until supplies last.