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Canadian Journal of Public Health

, Volume 99, Issue 3, pp 182–184 | Cite as

Non-medical Use of Prescription Opioids and Public Health in Canada

Urgent Call for Research and Interventions Development
  • Benedikt Fischer
  • Brian Goldman
  • Jürgen Rehm
  • Svetlana Popova
Commentary
  • 2 Downloads

Abstract

While the public health problem of psychoactive drug use is well recognized, the emerging phenomenon of non-medical use of prescription opioids has been largely ignored in Canada. Most evidence on this issue and related harms in North America to date come from the United States (US), where the prevalence of non-medical opioid use in key populations, as well as related morbidity and mortality, recently have risen substantially. Also, given the increases in the overall consumption of prescription opioids similar to those in the US, a substantial expansion of problems related to non-medical opioid use appears to be occurring in Canada. For example, recent major increases in the use of prescription opioids — rather than heroin — are documented for street drug users in Canadian cities. However, a comprehensive assessment of the problem of non-medical prescription opioid use is hindered by the spotty — or absent — nature of crucial indicators and data. We urge that the necessary efforts and resources for systematic assessment of the evolving phenomenon of non-medical opioid use and its key facets be established in Canada, and that policy-makers implement sensible intervention strategies targeting this problem within a public health framework, specifically avoiding unintended negative consequences (e.g., undermining access to pain treatment).

Key words

Opioid use pain treatment public health drug diversion prescription drugs 

Résumé

Le problème de santé publique que représente la consommation de substances psychotropes est bien connu, mais le phénomène nouveau de la consommation d’opioïdes d’ordonnance à des fins non médicales est largement négligé au Canada. Jusqu’à maintenant, la plupart des données probantes sur ce phénomène et les méfaits qu’il cause en Amérique du Nord viennent des États-Unis, où la prévalence de la consommation d’opioïdes à des fins non médicales dans certaines populations, ainsi que la morbidité et la mortalité connexes, ont beaucoup augmenté récemment. Or, on semble assister à une forte progression des problèmes liés à la consommation d’opioïdes à des fins non médicales au Canada en raison des hausses de la consommation globale d’opioïdes d’ordonnance, hausses qui sont semblables à celles des É.-U. Par exemple, de fortes hausses dans la consommation d’opioïdes d’ordonnance — plutôt que d’héroïne — ont été documentées récemment chez les utilisateurs de drogue dans les villes canadiennes. Cependant, l’évaluation approfondie du problème de la consommation d’opioïdes d’ordonnance à des fins non médicales est entravée par la rareté (ou l’absence) de données et d’indicateurs cruciaux. Nous encourageons vivement le Canada à prendre les mesures et à engager les ressources nécessaires à l’évaluation systématique du phénomène nouveau de la consommation d’opioïdes à des fins non médicales et de ses principales facettes, et nous exhortons les décideurs à mettre en œuvre des stratégies d’intervention raisonnables qui ciblent ce problème dans un contexte de santé publique, en évitant spécifiquement les conséquences non désirées (comme la restriction de l’accès au traitement de la douleur).

Mots clés

consommation d’opioïdes traitement de la douleur santé publique; détournement de médicaments; médicaments d’ordonnance 

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Copyright information

© The Canadian Public Health Association 2008

Authors and Affiliations

  • Benedikt Fischer
    • 1
    • 2
  • Brian Goldman
    • 3
    • 4
  • Jürgen Rehm
    • 2
    • 3
  • Svetlana Popova
    • 2
    • 3
  1. 1.Centre for Addiction Research of BCUniversity of VictoriaVictoriaCanada
  2. 2.Centre for Addiction and Mental HealthTorontoCanada
  3. 3.University of TorontoTorontoCanada
  4. 4.Mount Sinai HospitalTorontoCanada

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