In Ontario, someone dies of an opioid overdose every 14 hours. Most of them are related to prescription opioids, which are often prescribed for chronic pain.
With a reported 50 per cent of chronic pain patients facing wait times of six months or more to see a qualified specialist, prescribed opioids fill a health care gap.
Maybe this gap is the issue, and not the prescription that doctors are using to fill it.
As many of the thousands of men and women who have lost their jobs in the manufacturing sector could tell you, chronic pain doesn’t disappear when your job does.
We like to think of the people who use and sell drugs as criminals, not laid off assembly line workers with chronic pain conditions and reduced prospects.
The U of T’s Mowat Centre estimates that Ontario has lost 300,000 manufacturing jobs since the year 2000. Many of these workers face an uphill battle transitioning to new industries.
For some, selling all or a portion of their meds becomes income replacement. A social assistance cheque for a single person provides approximately $600 per month.
Let’s say a chronic pain patient is prescribed 60 high dose oxycodone (the generic form of OxyContin) tablets each month ranging in street price between $20 and $40. Selling their entire prescription would generate $1,200 to $2,400 in additional monthly income.
This is an example of how harsh economic conditions and a strained healthcare system can influence the supply of the opioid drugs being sold on Ontario’s streets. And when times get tough, many turn to drugs to cope.
In the Eastern European nations that comprised the former Soviet Union, rates of injection drug use and HIV increased rapidly after the fall of Communist rule.
Times have been tough for Southern Ontario in recent years, dealing with job loss but also the environmental consequences of its manufacturing sector.
The Windsor, Ontario neighbourhood that I grew up in is coming to grips with a Cancer Care Ontario report that suggests it has a rate of lung cancer more than double Ontario’s provincial rate. The neighbourhood in the report is located between several manufacturing and industrial sites.
Each incidence of cancer in this neighbourhood has a story behind it, and family members trying to cope.
Some cancer patients receive prescription opioids to deal with chemotherapy related pain. While their family members turn to these drugs to cope with economic circumstances that left them under or unemployed and facing the additional burden of caring for sick family members.
Fears of opioid abuse are understandable, but if we ignore their economic and social context, we’re overlooking the root causes of the issue.
When this occurs, prescription opioids and the people that use them become our focus, and criminalization occurs.
Take the 2012 OxyContin reformulation for instance. OxyContin was a popularly prescribed drug, due in part to the influence of its manufacturer, which was convicted of misleading the public about its addictive potential. Afterward, the drug was reformulated to reduce its abuse potential.
Nowadays, organized crime outfits have stepped in to reintroduce the drug. It’s still sold as OxyContin, but the active ingredient has changed.
Before the OxyContin reformulation, the drug was prescribed by doctors and sometimes diverted to street markets by their patients.
Now, it’s sold illicitly by people without any medical qualifications. They don’t swear to the Hippocratic Oath either.
It’s no shock that the pills being sold aren’t OxyContin at all, but instead fentanyl, a drug 100 times more potent. Nor that Ontario has more overdose fatalities than ever in its history.
Drug use is often described as being symptomatic of a bigger issue in a person’s life.
Why aren’t we applying the same logic to our communities?