OxyContin replacement still powerfully addictive: MDs
Published Thursday, March 1, 2012 10:58PM EST
The makers of OxyNEO, the drug replacing painkiller OxyContin in Canada, say the new pill will prevent abuse -- but doctors and people whose lives have been affected by the drug say the new pill is just as addictive.
The drug's makers, Purdue Pharma Canada, announced plans to replace OxyContin in February. Its replacement, OxyNEO, contains the same quantity of active ingredient oxycodone, but is harder for addicts to crush in order to inhale.
The decision followed years of concerns about the drug's strongly addictive properties, and came just as several Canadian provinces announced they would no longer fund oxycodone-based drugs.
But while it may deter addicts who have been crushing or melting the pills in order to inject or snort the drug, the change will do little to deter the many addicts who ingest it in pill form, Dr. David Juurlink said Thursday.
"People can be addicted to (opioids) and OxyNEO by taking it by mouth," Juurlink, head of clinical pharmacology and toxicology at Toronto's Sunnybrook hospital, told CTV's Canada AM. "The notion that this new formulation is going to make a major difference in this problem is not correct."
Oxycodone is from the opioid family of drugs, which also includes codeine, heroin and morphine. It is prescribed for pain relief, but can quickly become addictive with extended use. Since OxyContin's introduction in the mid-1990s, it has become a popular street drug and a leading cause of opioid-related overdoses, killing 300 to 400 people in Ontario each year.
Juurlink says the switch to OxyNEO is a step toward making the drug more difficult to abuse, but is only one piece of the solution.
"It's a multi-faceted problem," he explained. "The crux of the problem (is that) we don't have very good treatments for pain generally."
Those that are the most effective are also the most addictive, something many doctors didn't realize during OxyContin's early days on the market, he said.
"In the late 1980s, 1990s, and into the 2000s, doctors became very comfortable prescribing opioids," he said. "Undoing what has happened over the last 25 years is going to be very difficult. Doctors continue to prescribe these drugs despite knowing (of their dangers)."
Experts also warn that other highly addictive prescription drugs are surpassing OxyContin in popularity on the streets.
Amy Graves lost her younger brother last year to hydromorphone, a narcotic pain reliever commonly known as dilaudid.
Josh Graves was only 21 when he mixed dilaudid with alcohol at a house party in Nova Scotia -- a toxic mix his body couldn't handle.
Graves has since been speaking out against the proliferation of prescription drugs on the streets and is calling for more education about their deadly effects. She also says governments across Canada should invest more money and resources into long-term detox programs.
"I talk to addicts ... and they say they found bigger and better things, drugs that are more potent than OxyContin and easier to abuse," Graves told CTV News, adding that dilaudid has become the drug of choice in parts of Nova Scotia.
She introduced CTV News to Brendan Clarke -- a former dilaudid user.
"When you are snorting, it's nauseous but you feel good. There is a rush of euphoria. Some people say it is better than sex," he said.
Dilaudid pills he says, sell on the street for between $4 and $60 per pill, depending on the strength. Suppliers are usually people who have been prescribed the medications and then sell the pills.
Clarke is now in a government-sponsored methadone program, with prescribed doses of the narcotic to help him wean off his need for drugs. "They take over your life," Clarke said.
Abuse of fentanyl, another type of pain medication, seems to be on the rise as well.
Fentanyl is more potent than morphine and it's often administered to cancer patients in the form of a skin patch, which releases the medication over time.
Addicts who abuse these patches are playing with fire, warns Dr. Rita Shahin, Toronto Public Health's associate medical officer of health.
"It's more potent and it's difficult to judge the dose when they scrape the material off the patches," Shahin told CTV News. "So the risk of an overdose is quite serious, one we are worried about."
Graves says those switching from OxyContin to another painkiller are increasing their chances of overdosing due to unfamiliarity with different drugs and their dosages, noting several recent deaths in the Annapolis Valley.
The good news, Shahin said, is that the number of people signing up for methadone treatments in Toronto has tripled since the Ontario government announced it's phasing out OxyContin. There is now a waiting list.
"Some are seeing this as an opportunity to get off their addiction," she said.
Calgary's Linda Gardiner experienced the (drug's effects) OxyContin's in a tragic way, when her son Chad took his life while battling an addiction with that drug. She says she didn't know much about oxycodone at the time of his death, but soon found out he'd been taking 500 milligrams a day -- after starting at 20 milligrams per day following a car accident a year earlier.
Calling the drug's effects "devastating," she said she believes the switch to OxyNEO is a transparent attempt by Purdue Pharma to place blame on the addicts.
"(The new drug is) the same thing," she said. "They're focusing on people abusing it (to take) the responsibility off of themselves."
With a report from CTV's medical specialist Avis Favaro and producer Elizabeth St. Philip