A Toronto doctor and a Halifax lawyer say it’s time Canada’s health minister takes power opioids away from doctors.
Dr. David Juurlink and Matthew Herder published a commentary in this week’s Canadian Medical Association Journal calling on Ginette Petitpas Taylor to recall high strength opioids.
They argue the availability of high dosage drugs like fentanyl, oxycodone and morphine normalizes their use, when lower doses could be used instead.
“We think on balance these products do more harm than good,” Matthew Herder said in an interview with CBC Radio’s Mainstreet in Halifax. “We think, unfortunately, this step of issuing a recall is necessary at this stage.”
A high-strength formulation is equivalent to 200 milligrams of morphine per day, according to the peer reviewed commentary.
Herder, who is Dalhousie University’s Health Law Institute Director, points to the Protecting Canadians from Unsafe Drugs Act, which allows the health minister to recall a drug she feels is unsafe.
He admits this idea will not help people dying from street drugs laced with powerful opioids, but it could help people struggling with addiction from prescribed medication.
“Canada’s opioid crisis is probably several opioid crises, not just one,” said Herder.
Nearly 4,000 Canadians died in 2017 last year from an opioid overdose.
British Columbia doctor backs the idea
B.C. is the most impacted by Canada’s ongoing opioid crisis. By the end of September, 1,143 people had died of illicit drug overdoses in the province.
B.C.’s coroner service believes the majority of those deaths involved fentanyl. The province is even suing pharmaceutical companies.
The executive director of B.C.’s Centre on Substance Use said it’s hard to know how many of those deaths came from people initially hooked on opioids for pain but even saving a few lives is worth it.
“Clinical practice has fallen behind scientific evidence, despite the headlines demonstrating all the harms over opioids in our society,” Dr. Evan Wood told CBC Radio’s Daybreak South.
There are risks to lowering doses, including withdrawal. Wood believes doctors could still effectively help manage patients, even if the most powerful opioids are unavailable.
“At those high doses, the risk of fatal overdose or other harms is really the risk, and there are guidelines arguing against the use of those high doses in the chronic pain context,” he said.
CBC requested comment from the health minister but has not yet received a response.