Brian Cross, The Windsor Star http://www.theprovince.com/health/Prescription+drug+abuse+skyrockets+Windsor+area/4209782/story.html#ixzz1D6i81f00
The number of people seeking treatment in Windsor for addiction to prescription drugs is more than five times the provincial average and the number for women is even higher, experts in the field say.
Seven hundred and twenty-six of the 1,650 people entering the local detox centre as they went through withdrawal in 2009 listed prescription opioids as one of their primary substances, compared to 527 of the 1,599 entering detox two years earlier.
Alcohol is "not the big one anymore," said CAW Local 444 employee assistance program rep Bruce Malcolm, who sends Chrysler workers for treatment. "Most of them are Oxy-Contin or Percoset."
These are regular folks, most of whom have not had addiction problems in the past. But they get an injury, or surgery, or suffer some sort of chronic pain, and painkillers are prescribed.
"And unfortunately before they know it they start missing time and they start misappropriating the dosages. And before you know it they're buying them elsewhere," Malcolm said.
Drug addiction among women in Windsor has reached "epidemic" levels and the wait for help is at least six months, according to the operator of a women's treatment centre.
"We have an epidemic of women who are hooked on narcotic pain relievers; it's overwhelming us," said Deborah Gatenby, executive director of the House of Sophrosyne, a women's addiction treatment centre.
Provincially, 5.2 per cent of people seeking drug treatment are addicted to prescription opioids. But locally, in the region covered by the local health integration network, 27.8 per cent of people and 39 per cent of women seeking treatment are hooked on prescription opioids, which is eight times the provincial average, Gatenby said.
A U.S. study showed that 85 per cent of women and 79 per cent of men entering treatment for opioid addiction were first exposed to them through a prescription to treat pain.
Pat Keenan, who was the Local 444 EAP rep before retiring two years ago, watched OxyContin use steadily grow. "From occasionally to just about the everyday drug of choice for everybody."
The reason is fairly simple: "You can get scripts, and when you can't get scripts you can buy them off the street."
Percosets sell on the street for $3 or $4 for a five-milligram dose. A 10-milligram dose of OxyContin sells for $5, while 20-milligram doses sell for $8 to $10. Stronger doses of 40 milligrams sell for $12 to $15 and the 80 milligram pills sell for $35.
A recent study showed prescriptions for oxycodone -- the drug in both OxyContin and Percoset -- rose 900 per cent from 1991 to 2010 in Ontario. One of the reasons is there's nothing preventing someone in Ontario from going to many different doctors and getting multiple prescriptions.
Ontario Health Minister Deb Matthews is worried about what's happening. "We have a major problem on our hands in Ontario," she says of the rapidly rising use -- and misuse -- of prescription painkillers.
Alcohol is "not the big one anymore," said CAW Local 444 employee assistance program rep Bruce Malcolm, who sends Chrysler workers for treatment. "Most of them are Oxy-Contin or Percoset."
These are regular folks, most of whom have not had addiction problems in the past. But they get an injury, or surgery, or suffer some sort of chronic pain, and painkillers are prescribed.
"And unfortunately before they know it they start missing time and they start misappropriating the dosages. And before you know it they're buying them elsewhere," Malcolm said.
Drug addiction among women in Windsor has reached "epidemic" levels and the wait for help is at least six months, according to the operator of a women's treatment centre.
"We have an epidemic of women who are hooked on narcotic pain relievers; it's overwhelming us," said Deborah Gatenby, executive director of the House of Sophrosyne, a women's addiction treatment centre.
Provincially, 5.2 per cent of people seeking drug treatment are addicted to prescription opioids. But locally, in the region covered by the local health integration network, 27.8 per cent of people and 39 per cent of women seeking treatment are hooked on prescription opioids, which is eight times the provincial average, Gatenby said.
A U.S. study showed that 85 per cent of women and 79 per cent of men entering treatment for opioid addiction were first exposed to them through a prescription to treat pain.
Pat Keenan, who was the Local 444 EAP rep before retiring two years ago, watched OxyContin use steadily grow. "From occasionally to just about the everyday drug of choice for everybody."
The reason is fairly simple: "You can get scripts, and when you can't get scripts you can buy them off the street."
Percosets sell on the street for $3 or $4 for a five-milligram dose. A 10-milligram dose of OxyContin sells for $5, while 20-milligram doses sell for $8 to $10. Stronger doses of 40 milligrams sell for $12 to $15 and the 80 milligram pills sell for $35.
A recent study showed prescriptions for oxycodone -- the drug in both OxyContin and Percoset -- rose 900 per cent from 1991 to 2010 in Ontario. One of the reasons is there's nothing preventing someone in Ontario from going to many different doctors and getting multiple prescriptions.
Ontario Health Minister Deb Matthews is worried about what's happening. "We have a major problem on our hands in Ontario," she says of the rapidly rising use -- and misuse -- of prescription painkillers.
She's hoping recently passed legislation allowing the government to track the prescribing patterns of patients, doctors and pharmacies will help prevent people from double doctoring, getting inappropriately high dosages or getting refills too frequently. She hopes it will be up and running some time this year.
"For physicians who don't know their patients really well, it will be a really, really useful tool," she said.
"It will allow doctors to know, before they prescribe, whether a patient has had a recent prescription from another physician."
Matthews said she had her eyes open to the rising use of prescription narcotics when she went on a ride-along in her hometown of London with an officer who worked with sex trade workers. "What I learned ... was that virtually all the women working in the sex trade on the street were addicted, and many were addicted to prescription narcotics."
Hotel-Dieu Grace emergency medical director Dr. Gord Vail has been involved in confrontations with patients desperately seeking narcotics.
"Lots of people come in and say 'I've lost my script, it's flushed down the toilet, my landlord took it, I had to move and the movers lost it.' We get every sob story you can think of."
Vail said patients resorting to the already overloaded ERs for painkillers is becoming a bigger problem because of the shortage of family doctors who can adequately monitor patients suffering chronic pain, prescribe refills and make adjustments in dosage and drug that are appropriate. That leaves people to either go to walk-in clinics, most of which refuse to refill narcotics because they don't know the patient, or go to the ERs.
"It puts us in a hard place to make that decision," said Vail, who is also his hospital's chief of staff. "They come in and say they're on OxyContin at some ridiculously high dosage and it's up to us to decide if that's appropriate or should be continued."
And there's no scan or blood test that can tell you a person's back pain is so severe he needs a narcotic painkiller.
"So it's up to us to decide is this person being truthful," Vail said. "Are they in a lot of pain, or is it something they're going to sell on the street two minutes later?"
Doctors are prescribing powerful and addictive drugs like OxyContin to treat chronic pain, a condition that only started being recognized about 15 years ago as a legitimate condition, said Dr. Allan Gordon, director of the Wasser Pain Management Centre at Mount Sinai Hospital in Toronto. Currently, between 20 and 30 per cent of the population has it -- back pain, joint pain, fibromyalgia. And alternative treatments to drugs, such as physical therapy, aren't always easy to access. So doctors turned to opioids like Percoset and OxyContin. "I think opioids can be effective and certainly do work," said Gordon. "But you have to be very cautious with who uses them and what restraints and boundaries you employ."
Every patient needs a risk assessment, a list of questions on such issues as family history of addiction that help a doctor gauge the risk of addiction, he said.
"Not everyone is equal. Ninety per cent of the population, if you give them this medication there's not going to be a problem. But with 10 per cent there's going to be a problem."
Mellissa, a 27-year-old with two kids and a job as a personal support worker, was prescribed Percoset for a herniated disc more than five years ago. When her doctor cut her off, a friend introduced her to OxyContin. "It started off with just one. They're horrible, they're the devil, those things," she said. Within a month she was taking massive quantities -- up to 400 milligrams a day. "I could spend anywhere from $80 to $250 every day," she said, recalling how she'd pawn possessions and borrowed money to pay for drugs. "Now I look back, I don't know how I got the money."
She's thankful she got off Oxy by entering a methadone maintenance program. "It saved my life, because if it wasn't for that I would probably have lost my children, my job and myself."
"For physicians who don't know their patients really well, it will be a really, really useful tool," she said.
"It will allow doctors to know, before they prescribe, whether a patient has had a recent prescription from another physician."
Matthews said she had her eyes open to the rising use of prescription narcotics when she went on a ride-along in her hometown of London with an officer who worked with sex trade workers. "What I learned ... was that virtually all the women working in the sex trade on the street were addicted, and many were addicted to prescription narcotics."
Hotel-Dieu Grace emergency medical director Dr. Gord Vail has been involved in confrontations with patients desperately seeking narcotics.
"Lots of people come in and say 'I've lost my script, it's flushed down the toilet, my landlord took it, I had to move and the movers lost it.' We get every sob story you can think of."
Vail said patients resorting to the already overloaded ERs for painkillers is becoming a bigger problem because of the shortage of family doctors who can adequately monitor patients suffering chronic pain, prescribe refills and make adjustments in dosage and drug that are appropriate. That leaves people to either go to walk-in clinics, most of which refuse to refill narcotics because they don't know the patient, or go to the ERs.
"It puts us in a hard place to make that decision," said Vail, who is also his hospital's chief of staff. "They come in and say they're on OxyContin at some ridiculously high dosage and it's up to us to decide if that's appropriate or should be continued."
And there's no scan or blood test that can tell you a person's back pain is so severe he needs a narcotic painkiller.
"So it's up to us to decide is this person being truthful," Vail said. "Are they in a lot of pain, or is it something they're going to sell on the street two minutes later?"
Doctors are prescribing powerful and addictive drugs like OxyContin to treat chronic pain, a condition that only started being recognized about 15 years ago as a legitimate condition, said Dr. Allan Gordon, director of the Wasser Pain Management Centre at Mount Sinai Hospital in Toronto. Currently, between 20 and 30 per cent of the population has it -- back pain, joint pain, fibromyalgia. And alternative treatments to drugs, such as physical therapy, aren't always easy to access. So doctors turned to opioids like Percoset and OxyContin. "I think opioids can be effective and certainly do work," said Gordon. "But you have to be very cautious with who uses them and what restraints and boundaries you employ."
Every patient needs a risk assessment, a list of questions on such issues as family history of addiction that help a doctor gauge the risk of addiction, he said.
"Not everyone is equal. Ninety per cent of the population, if you give them this medication there's not going to be a problem. But with 10 per cent there's going to be a problem."
Mellissa, a 27-year-old with two kids and a job as a personal support worker, was prescribed Percoset for a herniated disc more than five years ago. When her doctor cut her off, a friend introduced her to OxyContin. "It started off with just one. They're horrible, they're the devil, those things," she said. Within a month she was taking massive quantities -- up to 400 milligrams a day. "I could spend anywhere from $80 to $250 every day," she said, recalling how she'd pawn possessions and borrowed money to pay for drugs. "Now I look back, I don't know how I got the money."
She's thankful she got off Oxy by entering a methadone maintenance program. "It saved my life, because if it wasn't for that I would probably have lost my children, my job and myself."
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