Heroin-assisted treatment and politics-based medicine

'Ms. Ambrose doesn’t have any medical education'

A lawyer for some of the patients in the SALOME study says he’ll consider options for a legal response to Rona Ambrose’s decision to block access to diacetylmorphine.

Scott Bernstein, a lawyer for the Pivot Legal Society, which is representing 22 SALOME patients as well as the B.C. Association of People on Methadone, said he will explore all legal options once the exact details of the new regulations are known. He said he is concerned by the fact the government can “close off” Health Canada’s ability to make decisions.

“Ms. Ambrose doesn’t have any medical education,” he said. “Taking this decision out of the hands of experts … and making a decision based on politics – is that how we want to approve medical care in this country?”

On that point, Mr. Bernstein has previously pointed to a letter written by Ms. Ambrose’s predecessor, Leona Aglukkaq, to provincial health ministers on the subject of Oxycontin. Heroin and oxycontin are perhaps not perfectly analogous, but the principles invoked by Ms. Aglukkaq do make for an interesting read now.

As Health Ministers, we have the tremendous responsibility of making decisions every day that have direct impact on the lives of Canadians from coast to coast to coast. These issues are often complex, with conflicting opinions on each side about what the right balance of individual responsibility and government action should be.

There is no basis in the Food and Drugs Act for the Minister of Health to withhold approval of a drug where the drug is otherwise considered safe and effective for its recommended use. The law does not permit approval to be withheld on the basis of misuse.

In terms of the prescription drug OxyContin, I have heard heartfelt pleas from doctors and patients who speak to the positive impact it has had in treating chronic pain.

And I have heard heartbreaking stories of abuse and addiction destroying the lives of individuals and families.

Both sides of the argument are compelling, and require a response from us as Health Ministers.

During our recent Health Ministers Meeting, the request was made for me to delay approvals of generic versions of OxyContin. At that time, I committed to relay any research you had related to this request on to Health Canada scientists for their consideration. Shortly after our meeting, my officials held a teleconference with your officials to review any research.

I want to be crystal clear: I do not believe that politicians should pick and choose which drugs get approved. While intentions may be noble in this circumstance, what stops future politicians from caving into public pressure and allowing unproven, unsafe drugs on the market once political pressure starts to mount?

A drug approval process based on politics is a recipe for disaster.

Meanwhile, here is a note Libby Davies posted to Facebook last night.

I see that the minister of health is at it again – denying critical treatment in the form of herion maintenance to chronic drug users, by changing the regs. They play politics with people’s lives. It was quite disgusting to see that the Cons used their political dogma on this, as a fund raising letter! How’s that for exploitation? To all the docs, researchers, activists, and fine people who actually try to help people, please know we support you. We will continue to stand up for compassion, and evidence based decisions.

Ms. Davies and Dany Morin have now raised the matter with Ms. Ambrose via Twitter and the NDP’s virtual QP.

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