OTTAWA – Health Minister Rona Ambrose suggested Monday there could soon be movement from Canada on U.S. pleas to outlaw addictive, generic formulations of the painkiller OxyContin amid a simmering dispute between the two countries.
“I have been examining this issue, and as you know in the speech from the throne, we did make a commitment to move forward with a prescription drug strategy, and so you’ll see that coming forward in the next while,” Ambrose said in Vancouver.
Ambrose made the comments as U.S. Senate confirmation hearings loom for Gil Kerlikowske, President Barack Obama’s pick to take over the powerful Customs and Border Protection agency.
As head of the White House’s Office of National Drug Control Policy, Kerlikowske has spent years trying to curtail what he’s described as a prescription drug abuse “epidemic” in the United States.
The United States is hardly on its own grappling with the problem — in 2010, for the first time, Canada inched past the U.S. to become the highest opioid-consuming country, per capita, on the planet.
As many Ontario residents now die from opioid overdoses as they do in car accidents, according to a recent study by KFLA Public Health, based in Kingston, Ont.
Nonetheless, Kerlikowske’s appeals to Canada to ban formulations of the drug that can be easily crushed, snorted or injected by addicts — and have shown up in U.S. border communities despite being outlawed stateside by the Federal Drug Administration — were rebuffed by Ambrose’s predecessor, Leona Aglukkaq.
The former health minister refrained from banning generic forms of the painkiller, instead directing provinces to deal with the problem. Ambrose, meanwhile, has offered no specific details about what the government might have planned.
Ontario, British Columbia, Saskatchewan, Manitoba and Prince Edward Island now only cover prescriptions for OxyNEO, the tamper-resistant version of the drug made by Purdue Canada — but that coverage generally only applies to senior citizens on social assistance.
The provinces have no control over what private health insurers will pay for, and late last year, Health Canada gave six drug companies the green light to begin manufacturing the generic forms of the drug.
“In Canada, the decision was made that because the original OxyContin had been determined by Health Canada to be safe and effective previously, they decided to continue with that decision and therefore allowed generic formulations to be made — the crushable, more addictive version,” Tara Gomes, lead scientist at the Ontario Drug Policy Research Network, said in a recent interview.
“If it’s approved by Health Canada, then people can provide and purchase it.”
American authorities were alarmed when the addictive formulation of OxyContin began showing up in U.S. border towns between August 2010 and February 2012, when it was the only version available in Canada compared to the tamper-resistant formulation that was being widely prescribed in the United States.
A study headed by Gomes determined that the addictive form of OxyContin found its way to the U.S. via Canada for 18 months — the time period between when Purdue introduced the new form of the drug in the United States and Canada, respectively.
“At the Detroit-Windsor tunnel, there was a large spike in dispensing of the OxyContin tablets that aligned perfectly with when the switch happened in the United States,” she said in an interview.
“In that time period, it amounted to about 250,000 excess Oxy tablets dispensed in that period that we would hypothesize were taken across the border to be sold in the U.S.”
By February 2012, Purdue introduced reformulated OxyContin tablets in Canada, too, under the OxyNEO name.
Gomes is planning another study to see if generic Canadian OxyContin is still making its way to the United States.
“We need enough time to pass to get the more recent data; it’s definitely in the works to replicate the study in this newer time period,” she said.
She added the discrepancies between various jurisdictions on OxyContin isn’t just a Canada-U.S. problem — it’s an issue that threatens to flare up among the provinces, as well.
“In Ontario, it’s slightly harder to come by from a public drug coverage perspective, but if other provinces nearby have different availabilities and different listings on their formularies, you could see problems emerge across provincial borders, not just international borders,” she said.
“This is a prescription medication and so it’s down to the health agencies to make decisions on the availability. It all becomes very difficult when it’s such a highly sought-after drug on the black market.”