OxyContin changing format to bypass abuse

by Alicia McCutcheon

ONTARIO—In the latest move under Ontario’s Narcotic Strategy, the government announced last week that the narcotic OxyContin, manufactured by Purdue Pharma, would be pulled from pharmacy shelves across Canada by the end of this month in an attempt to curb abuse of the highly addictive painkiller.

OxyContin will be replaced with a new formulation of the drug called OxyNEO, which, while still a painkiller, has different properties, explained Mindemoya Guardian pharmacist Mike Bondi.

“It’s harder for people to crush then snort or inject,” he told The Expositor, describing the new project. “If you mix it with water, it will turn into a jelly.”

Mr. Bondi said that over the past nine years he has seen a huge jump in prescriptions to OxyContin, calling it “over prescribed.” However, he said, thanks to Manitoulin doctors coming together to form their own strategy on over prescriptions of the narcotic, the pharmacist has seen a definite decline in physicians prescribing the product over the past two years.

The government has given one year for patients who are currently prescribed OxyContin through the Ontario Drug Benefit, and pay no fee for the product, to switch to OxyNEO starting February 29. Furthermore, doctors who wish to prescribe OxyNEO to a patient must now have the approval of the provincial government. They must fill out paperwork explaining that all other courses of opiate-based narcotics have failed at pain control, effectively pleading the case of the patient for acceptance into the ‘exceptional access program.’ This is the route required for access to some cancer treatment drugs too, Mr. Bondi explained.

“Originally, OxyContin was brought into the market for very specific reasons, such as pain control for cancer patients,” Mr. Bondi continued. “The formulation of this pill was so you could crush it and get a long acting, euphoric high.” The pharmacist added that long-acting oxycodone, or OxyContin, is the most highly prescribed product for exactly that purpose—the long-acting formulation. Short-acting oxycodone does not fall under the new law.

The federal government’s Non-Insured Health Benefits Program (NIHBP), which provides drug coverage for over 800,000 First Nations and Inuit people, will mirror the Ontario Drug Benefit program in terms of government approval, Mr. Bondi said.

This has caused First Nations leaders from across the province to voice their disapproval, specifically Nishnawbe Aski Nation Grand Chief Stan Beardy, who represents 49 First Nations communities. Chief Beardy went public last Friday, sharing that at least half of his member population were addicted to opiates, including OxyContin, yet there are very few treatment or detox centres to deal with the onslaught of patients this will soon mean.

“The government is now saying they know there’s a big problem,” Mr. Bondi said. “I think this is a good thing.”

For those who pay cash or are on a plan that will cover OxyContin, or OxyNEO, this rule will not apply—a doctor can prescribe as usual, the pharmacist explained. However, he added, there are very few people on Manitoulin who pay for prescriptions due to its demographic make up—First Nations (NIHBP), senior citizens (Ontario Drug Benefit) and those eligible for the Trillium Drug Program (high prescription costs compared to household income).

“Under the Narcotic Strategy, this is an ongoing strategy and pretty soon for everyone who is prescribed a narcotic, pharmacies will have to obtain a copy of their health card,” Mr. Bondi continued. “The information will then be passed on to a database. This is to prevent doctor and pharmacy shopping (for people who attempt to beat the system and obtain multiple prescriptions)—it will all come to a screaming halt.” This latest strategy is expected to be up and running by the summer.