Health Minister Leona Aglukkaq might have a point when she argues that banning a generic version of OxyContin, as some provincial governments have urged her to do, would amount to unfairly taking aim at a “tempting political target,” while in the process ignoring proper procedure for approval of prescription drugs.
But if Aglukkaq is right that new versions of highly addictive controlled-release oxycodone should be allowed for the sake of patients who would benefit, she leaves open a bigger question: Why has Conservative policy stubbornly insisted on pretending that prescription drug abuse is an issue separate from the abuse of illegal drugs?
In fact, not only are prescription drugs excluded from the government’s National Anti-Drug Strategy, that federal umbrella program doesn’t even include alcohol. Why segregate such clearly related subtance-abuse problems? I’ve never heard a plausible answer from a federal politician or policy-maker in the course of writing on the strategy from a couple of angles (once on its advertising component and again on quietly made changes to spending under the strategy).
This is hardly a new point of dispute. Back when the Conservatives were announcing the first five-year phase of the strategy in 2007, the Canadian Executive Council on Addictions, which represents addiction agencies across Canada, pleaded with the government to broaden its focus to include prescription drugs and alcohol. It hasn’t happened.
Yet with the generic oxycodone issue in the air, the government is suddenly sounding very concerned about prescription drug abuse. Aglukkaq said in the House during Question Period on Monday that “prescription drug abuse is bigger than one specific pill.” (Undoubtedly true.)
She then described her department’s way of handling of oxycodone as a tough licensing system that would prevent illegal sales. Pressing on about the need for more to be done, though, she added: “That is why I am also calling on the provinces and the territories and the medical professionals to look at what they can do to fight this problem.”
I’m pretty sure what she’ll find is that top addiction treatment professionals will again urge—as they have been for years—an integrated approach that takes into account the close links among the abuse of booze, of pills from drug stores, and of drugs bought on the street.
Back in the 2008, the Centre for Addiction and Mental Health recommended four ways to improve the federal anti-drug policy. The first two proposals were to bring alcohol and prescription drugs under the strategy. It made sense then and if anything seems even more essential now.
It’s worth remembering that the Justice Department’s January, 2010, evaluation of the National Anti-Drug Strategy drew attention to the fact that U.S. policy, unlike the Canadian approach, does not artificially place prescription drugs in a separate silo from illicit drugs:
“[S]ome countries have drug strategies in place that are not focused exclusively on illicit drugs. For example, while the current U.S. National Drug Control Strategy includes a strong focus on illicit drugs, it also addresses substance use in general, and explicitly mentions abuse of alcohol and prescription drugs as issues of concern and in need of government action.”