T Nation

Canada Asks Drug Makers to Stop Marketing Opioids

#1

It turns out that recently the Canadian Health Minister sent a letter to various pharmaceutical companies just asking them to stop advertising opiates. Canada is the worlds second largest per capita user of opiates.

Note from the article that one medical professional thinks she is a bit daft not TELLING them, years after action was taken by the United States government.

I keep hearing about how everyone socially conscious needs to get themselves a Naloxone kit, in case they run into someone having an overdose. I won’t, I figure they ought to buy it themselves and bloody carry it around, and do think there is a fair bit of personal responsibility about getting horribly addicted in the first place.

Still, this isn’t Afghan smack hitting the streets, it takes complicity from doctors yeah whatever prescribing and the pharma companies in the first place stabbing the soils with their shovels looking for gold.

I voted for the current federal Liberal government and like a fair bit of what they have done, but this seems to be wet noodle fighting.

#3

Not surprising. The level of incompetence at the Federal level in Canada is staggering.

#4

Goddamn I can inspire a busy thread. …Um…I guess not.

#5

Chris Jericho is the intercontinental champion in new Japan pro wrestling. And that’s all the current events I know about Canada. If you ask Jericho, it’s all you need to know.

#6

Its not you, its just that we have a forum poster that makes it really difficult to have cogent conversations about pharma.

I’d say who but if you mention his name 3 times he’ll appear behind you with a “Free The Weed” shirt and stink up your house with patchouli oil.

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#7

You forgot the status of the share price in Maple syrup mining companies.

#8

My syrup is mined in Vermont.

#9

He also has the ability to be in several places at once. Everyone has taken a college class with him.

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#10

The issue I have with this opiate epidemic is the part in which a subset of people are suffering for no good reason. Some people require opiates to live a normal life as they go by day to day in chronic, unrelenting, moderate to severe pain. Chronic pain, especially severe chronic pain, is terrible, it’s draining and it can suck the joy out of everything.

People are panicking over opiate abuse, the resulting effect is a crackdown on prescription opiates which in turn causes people who suffer from chronic debilitating pain to be left suffering as the government clamps down on doctors prescribing opiates.

Im not trying to downplay the risk of opiates, they are highly addictive drugs, some more than others, with a high potential for abuse. It can sometimes be difficult for a doctor to differentiate between a chronic pain patient begging for relief and an addict begging for “pain relief” as both are quite similar, the difference being that typically addicts will usually try to convince the doctors to prescribe instant release opiates rather than slow release formulas (other differences as well).

The bulk of opiate abuse doesn’t come from doctors prescribing the substances, I’ll post a study when I get the chance but most people who abuse opiates acquire them first off a dealer or steal them from someone else who has acquired them.

The consequences for those who abuse opiates and the surrounding family members can be devastating, and I apologize if anyone has or has friends/family who have suffered consequences of opiate abuse is offended by this post, I’m giving my perspective on the issue. Opiate induced hypogonadism is a huge issue among those taking opiates for chronic pain, however a small body of evidence now exists suggesting tapentadol (an opiate pain medication with two mechanisms, one being acting as an agonist of the U opiate receptor and another as a norephedrine reuputake inhibitor, similar to tramadol but much stronger as tramadols main active metabolite is desmethyltramadol, the metabolite is primarily what gives tramadol pain relief I believe and tapentadols metabolites such as desmethyltapentadol have no analgesic activity and the unmetabolised product is what gives the pain relief.) Doesn’t cause a statistically significant drop in Testosterone levels compared to other opiates like Oxycodone and morphine, it also appears the potential for abuse of tapentadol is lower than that of other opiates, but that isn’t important just pointing out an interesting piece of information. Other issues with opiate pain medication include but are not limited too, profound respiratory depression, immunosuppression, nausea, drowsiness (impaired motor skills) etc. However it’s better than living in constant crippling pain, it’s all about the perceived benefit to risk ratio, and a life spent in crippling pain for many isn’t a life worth living, and these medications can provide adequate quality of life for those people.

My proposed resolution would be for pharmaceutical companies to employ more abuse deterrent mechanisms for opiates. Many slow release formulas are slow release because of a coating on the pill, people looking to get high can simply chomp down on the pill or suck off the filler to get essentially an instant release pill, this practice may be particularly dangerous as instant release formulations can be dosed much higher than instant release formulations, therefore giving the user a dose higher than they are used to and causing an overdose. Slow release formulations should be literally somehow impervious to abuse, now sure how the pharmaceutical companies could do this but I’m sure there’s a way. Anotherdeterrent of naloxone to opiates. Targin (Oxycodone/naloxone) has this and due to the addition of naloxone to the tablet, users cannot crush and inject the opiate effectively as naloxone blocks the effects of opiates, therefore significantly reducing the chances of overdose and abuse, however targin can still be crushed and taken orally, and from what I remember although I may be wrong is that a certain dose can be taken orally before naloxone kicks in to any significant degree therefore still giving a risk of a abuse as it could still provide a high. Slow release formulas should be uncrushable to prevent people injecting or snorting the compounds.

The fact that chronic pain patients are now suffering in terrible pain doesn’t help the opiate epidemic, some of these sufferers will turn to heroin or street drugs to help them cope with their pain, this is the opposite of what the government is trying to achieve. Alternatively many say marijuana helps with chronic pain. A new study just came out claiming it doesn’t benefit chronic pain however I believe it may as too many people say it helps, whether it actually reduces pain or makes people merely care about the pain less I don’t know. The fact chronic pain sufferers are getting punished for having chronic pain is ludicrous, similar to how people with low testosterone are getting punished for having low T.

Finally the argument for tolerance to opiates, Yea people build tolerance however periodically switching opiates (same morphine equivalent doses) may help stop the development of a tolerance, I’m not a doctor but This is my opinion on the opiate epidemic…

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#11

It seems that there is some movement here in Canada.

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#12

I think it’s sux…I remember the pre Trump era when you could walk in a pill mill get oxy, Viagra, & Xanax…& Bill it to insurance…this blows… Used to be the Michael Jordon of throwing Vicadin now I can’t even play #sad

#13

You just have to go to the docs on a Friday afternoon. Tell them you have a what ever and they’ll prescribe you enough oxy to knock you out so that you don’t bother them all weekend.

That little tip isn’t going to show up in any studies!:laughing:

#14

This guy has a pretty good take on the subject:

http://www.foxnews.com/opinion/2018/07/07/dr-marc-siegel-opioid-crisis-has-solution-here-it-is.amp.html

#15

I might try it…I’ve been to 4 different pain clinics since my pill mill got shut down… best I’m able to score these days is muscle relaxers & ibuprofen 800… & I’ve got history of injuries… only people’s I see getting good stuff is car accident folks & post surgery…

#16

I like Canada and all, but their regard for their version of the 1st ammendment lately has been lacking.
I guess it made a hero out of Jordan Peterson.

#17

Yeah, I am not a fan of the government hangin out in my treatment room.
Sometimes opioids are the only and best choice.
They are not the boogieman the media is making them out to be.
Some conditions take a couple of years to resolve the pain.
Just stay the hell away from my doctor and me. If I need opioids then let him write them.

These people are going to drive the price of heroin to the unaffordable range. Geez.

/rant

#18

I’m perfectly happy letting Drs write oxy scripts til nobody can feel anything, but if that’s the route we’re going we really need to stop saving people from ODs. Let em die and people will manage their drug use more appropriately.

I know I know. What about those headlines that read “local junkie finally ODs, has only himself to blame.” I’m aight with it

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#19

One common argument against having services such as Christian street missions running soup/drop in centres in high drug abuse areas is that the dealers can just say to someone, “don’t worry, if you get over your head with this shit, just lean on the services available.”

What kind of credibility does this argument have? I used to live in a town that had this same issue as a political football. It was a more conservative town, and I wonder if that is just what it is. Friends of mine from there are actually very supportive of 2 new safe injection sites opening up. there has been fierce opposition as to the NIMBY type of thing, ‘oh this will drive business out of the area.’

I actually do support the injection sites, I still won’t buy a Naloxone kit, they just have to fucking watch what they do in the first place. The injection sites might be helpful in improving health, preventatively saving cost, and might help them transition out of addiction.

thoughts?

#20

Raw chance I ran across this one:

I am hopeful that the impending legalization of Cannibis, now slated for October 17 (it was supposed to be now, July, but municipalities have to be able to adapt) will allow a law enforcement fuck down of the other shit that really buggers peoples’ lives. Pot can a bit, but alcohol has always had issues too and it has wide acceptance.

thoughts?

#21

Eh. That’s not really how that works irl. Dealers want you ‘addicted’ to their product but not so addicted that you’re stabbing people at 7 eleven. Prisoners have a hard time being repeat customers, as do released convicted felons on parole/probation.

I’d say if the safe sites are able to be cost effective, absolutely no reason not to.

Personally I just want consistency. What Pat and others often feel, is that they don’t need a lifeguard (society) on duty when it comes to their health. I’m 1000% down with that. But if that’s the route we’re going, I don’t want to have to deal with the reprecussions of THEIR actions. If you want to get addicted to vicadin, have at it. But stop sending ambulances for ODs, and stop stocking the ambulances with Nal for when they lie.

I’m willing to bet a considerable amount of money that in the coming years Canada is going to see a drop in drug deaths and the overall drug trade. Iirc thc is damn good at covering roughly 4/10 and below on the pain scale (I know, arbitrary, idk how to quantify pain).

It’s really really really hard to develop an opiod addiction from weed. Trust me.