OxyContin may no longer be manufactured in Canada, but the painkiller known as “hillbilly heroin” leaves behind a legacy of addiction, shattered lives and unanswered questions about the drug that will replace it. The drug company Purdue Pharma is replacing OxyContin with a new formulation called OxyNeo, which is supposedly harder to abuse because it can’t be crushed easily for snorting or injecting.
Canadians will still be able to get prescriptions filled for OxyContin during March, but doctors are being asked to start prescribing OxyNeo. Canada’s national health service, Health Canada, has removed OxyContin from the list of prescription drugs that it pays for. Ontario and several other provinces have gone even further, restricting access not only to OxyContin, but OxyNeo as well. Only patients suffering from cancer pain will be automatically eligible for OxyNeo prescriptions. For patients suffering from other types of chronic pain, doctors will have to prove that no other painkiller works.
“The restrictions to OxyNeo funding being imposed by some provinces are surprising. This product was specifically designed to help discourage misuse and abuse of the medication,” Purdue Pharma said this week in a statement. “Purdue Canada does not claim that OxyNeo will prevent all tampering for the purpose of drug diversion, misuse and abuse. However, it is a step in the right direction.”
Canada was fertile territory for OxyContin when it was first introduced in 1990s. Doctors immediately began prescribing it to treat pain and abuse of the highly addictive drug became common. Canada now has the second-highest rate of opioid consumption in the world, after the United States. The annual number of deaths in Canada related to opioid use is double that of HIV infection.
Nowhere is the addiction problem worse than in Canada’s native Indian population. Over half the adults in some First Nation reserves are addicted to OxyContin and other opioids. Few addiction counselors or treatment programs are available to address the problem
“The removal of OxyContin from the Canadian market threatens to exacerbate this problem, especially in northern and remote First Nations, some of which are already battling widespread opioid addictions and have declared states of emergency,” said Dr. Carolyn Bennett, a Liberal critic of Prime Minister Stephen Harper. “Stephen Harper must take responsibility for his total failure to address the addictions crisis. The Conservative government must take immediate steps to provide emergency services for those suffering from OxyContin withdrawal.”
Others health professionals say the problem isn’t limited to First Nation communities. “We are at the onset of a public health crisis as Oxycontin use has led to an increase in the use of other drugs such as heroin, as well as concerns surrounding the use of injectables and the contraction of HIV or Hepatitis,” said Liberal health critic Dr. Hedy Fry.
While OxyContin will be harder to get legally, the underground black market for the drug is booming. Ontario police say the street value for OxyContin is about $20 a pill – and is likely to go higher as supplies dry up.