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Canada’s prescription opioid epidemic grows despite tamperproof pills

BMJ 2015; 351 doi: (Published 03 September 2015) Cite this as: BMJ 2015;351:h4725
  1. Owen Dyer
  1. 1Montreal

“Weak” doctors who cannot say no to their patients are driving Canada’s prescription opioid epidemic, the Canadian Medical Association’s annual general council heard this week, as new research showed that the mortality risk from chronic high doses may have been badly underestimated.

OxyContin (oxycodone), the drug most closely associated with the rapid spread of opioid prescribing across North America, has been replaced with a tamperproof formula called OxyNEO. But in Canada, where provincial drug formularies have mostly refused to cover the new drug, oxycodone prescriptions have fallen only to be replaced by other, often more powerful opioids, such as fentanyl and hydromorphone.

Opioid prescribing continues to rise overall, as do related deaths. Fatal overdoses in Ontario, Canada’s largest province by population, are almost as common as in the United States …

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