Friday, November 18, 2016

Living with the Harms of Prescription Drugs

Living with the Harms of Prescription Drugs
The harms associated with prescription drugs are :
a community issue ,
a family issue,
a healthcare issue,
a public safety issue,
an industry issue.

We all have a responsibility in addressing them.

"On June 10, 2004, my only child died suddenly and unexpectedly. Michael went to bed and never
woke up. The coroner who investigated Michael’s death determined that he died as a result of
“hydromorphone intoxication.” His death was ruled an accident, and no street drugs or alcohol were
in his system. His death was preventable.
My son and I shared a beautiful, close, loving relationship. He lived at home and was the focus of my
life. Michael was a thoughtful, generous, warm and caring soul with a smile that would light up a
room. He loved children and children loved him; he was extremely close to his family, had many
friends and had a successful business partnership.
However, things changed during Michael’s last year.
In the summer of 2003, Michael seemed easily agitated and upset over the slightest things. Even
though he tried to hide this from me, I sensed something was wrong, but made the mistake of
thinking this was due to the ups and downs of a new relationship. When I talked to him about it he
said “Mum, don’t worry I’m seeing a doctor.” It wasn’t until after Michael’s death that I learned that
his doctor prescribed him more than 13,000 pills in a period of 14½ months. The day before his death
Michael was prescribed a drug he had never taken before — Dilaudid®. The active ingredient in
Dilaudid is hydromorphone, one of the most powerful opioids ever synthesized.
The next morning Michael never woke up.
Unfortunately, this kind of indiscriminate prescribing is all too common. It breaks my heart when I
think back and imagine the anguish, both physical and mental, that he must have experienced from
the excessive amounts of highly addictive medication.
After Michael’s death, I began searching for answers. I realize now that two visits to the emergency
department in Toronto may have started Michael on a slippery slope. Twice in 2002, my son was
diagnosed with kidney stones. Both times he was treated and discharged with a prescription for
Percocet™, which is oxycodone. Neither the doctor nor the pharmacist warned us that Percocet could
be addictive. The use of opioids “as prescribed” is not sufficient to prevent patient harm. My son
died within two years of his first Percocet prescription.
The system failed Michael and it continues to fail others. It is my hope that First Do No Harm will lead
to a system that doesn’t fail others as it did Michael. We must bring about the necessary changes to
end the epidemic of death and addiction caused by prescription drugs by ensuring that they are
regulated, marketed, prescribed and used in an evidence-based manner.
This vignette also represents the many untold stories and is written for all the loved ones lost to a
system that failed them. We can and must do better." 
— Ada, mother


"I was a regular kid with a normal life in a good family. My parents were very supportive. No one else in my family did drugs: I was the black sheep. I started experimenting when I was just 15 and started smoking pot with my best friend who was 14. My friend’s dad used to take us to places we’d never get in and buy us beer. I thought he was super cool. One day his dad came home and dumped three piles of cocaine out of a baggie and took his line and told us to take a line. I was scared, obviously. I didn’t want him to think I was scared so I did it. Cocaine took my anxiety issues away. I tried opioids and they were even better than cocaine. I tried oxycodone and Dilaudid®. I kept hanging out with my friend and his dad. We started looking for drugs everywhere and using friends to get them. Drugs made me feel less shy and nervous around girls. In high school, drugs are very prevalent. Drugs became the focus of my life. I found a cheap supply pretty easily at first. My friend stole Dilaudid eight milligram pills from his dad, who had a prescription, and he’d sell them to me for a dollar. He only stole 20 at a time so his dad wouldn’t notice. Kids sold prescription drugs at school and it seemed safe as the pills are prescribed by a doctor. The problem is they aren’t safe. They are all addictive; I found opioids to be the worst. Eventually my cheap sources ran out and I started buying them from the street. I stole about $700 from my grandmother by “helping her” with groceries. I was 18 when I was charged with seven counts of theft for stealing cartons of cigarettes. I stole stuff from my cousin’s house. I was in detox more than 10 times. I just wasn’t ready to quit. The drugs had too much of a hold on me. I stole and sold necklaces and a camcorder for drug money. I stole my uncle’s handgun and was caught by the police while trying to sell it. I went to jail that night and then to court. I still had drugs hidden in my winter coat. I asked for a magazine and a pencil and used that to crush them up. I snorted them off the magazine in the courthouse holding cell. The only thing I wanted was that drug. Nothing else mattered to me. My parents were extremely angry and upset. I lied about how much I owed the dealers so my dad gave me $500. I paid what I owed and snuck back into the house with drugs. While my mom was still in bed, I crushed up and snorted pills. At 20 years old things changed drastically. After a night of drinking while on a mix of Dilaudid and other drugs, I robbed a late night motel. This time when I went to court I broke down and cried for everything I’d put my family and other people through. I was sentenced to four years in prison and was terrified. The withdrawal was horrific and lasted over a week. When I started feeling better, I was allowed outside. I was surrounded by concrete, but could look up at the sky. I remember breathing fresh air and vowing I’d never use drugs again. I believe everything happens for a reason. I worked out and graduated high school from prison. I got on a methadone program at prison and have stayed clean for four years. Today, I work with lots of young people so they don’t live through what I did. I’m involved with addiction services and tell my story at doctor’s conferences. I also have a blog to help kids and families: My life is so much better now without drugs. I wish I’d quit sooner." — Neil, young man recovered from prescription drug misuse.

First Do No Harm: Responding to Canada’s Prescription Drug 

"I signed up with the Toronto Police as a cadet when I was 17 years old. I was sworn in on my 21st
birthday at the rank of police constable. I was young, fit, loved hockey. I loved my life and had a
promising career ahead. Some injuries caused a shift in my back vertebrae, but I continued playing
hockey. I had a small bit of pain when I skated, but no pain on the job.
In 1989, after seven years in busy Toronto divisions, I moved to a smaller town to advance my career
as a police detective. A few years later I left the station for home and my car was T-boned. The impact
pinned my knees under the dash. I was x-rayed from head to toe at the hospital. Doctors said there
was “nothing significant.” I was told to take two weeks off and given a prescription for Percocet® for
the pain.
I had my eye on an upcoming promotion exam and after two weeks I went back to my full duties. The
pain in my lower back worsened and a rheumatologist determined that there had been a spinal shift.
The doctor gave me a prescription for 100 Percocet® while waiting for surgery to fuse my vertebrae.
The surgery that should have taken away the pain was a complete failure. I was forced to withdraw
abruptly from Percocet seven days after surgery. The withdrawal was horrific and pain was still there.
Doctors scheduled a second back surgery six months later. Meanwhile, I went back to work.
I never looked for Percocet or took pills improperly until doctors flatly refused to give me any more.
As a cop, I knew certain people around town who had Percocet. I found medication where I could
from friends and even from criminal acquaintances. I was in chronic pain. My tolerance kept building,
so I had to keep increasing the number of pills I took. I went from 2 to 4 to 6 pills a day. Unfortunately,
the second surgery was also a failure. I was prescribed Percocet again. This time I tapered down with
the help of the doctor despite the pain. Eventually, I went to Tylenol 3® and diazepam. I was off all
narcotic pain meds for four to six months.
Then, my doctor prescribed OxyContin®. I was told it was a better drug and the “addictive
component was less.” I was at square one and taking more pills than ever. My doctor’s solution was
for me to claim to be an addict just to get access to the methadone clinic to taper off Percocet.
People in chronic pain shouldn’t be victimized. I was a respected officer. Now, I had to hide from my
own guys just to sneak into the meth clinic and sit for hours waiting for my “carry.” I would cover my
head and worry I’d be sitting with someone I’d arrested as a plain clothes detective. I wasn’t asked to
act like an addict, but told I was one since methadone in the clinic was not for pain management, but
for drug treatment. I was horrified. Methadone was very effective for pain management.
My supervisors found out and I was justifiably disciplined for some of my actions, but not dismissed. I
was labeled a “druggy” by administration and my colleagues. It was the loneliest time of my life.
Unable to do the job without pain medication, I felt I had no choice and walked away from my career.
The next 10 years I was in and out of boring jobs. The pain clinic saved my life. I now combine
prescription and non-prescription treatments to manage pain. I use Percocet and methadone in very
low doses. I’ll be trying an experimental electrical implant device this spring. Because my pain is
well managed, I’ve been able to build a successful private investigation business and teach part-time
as a college professor. I’m also involved in overseas humanitarian missions in Haiti. I have my life

— Peter, former police officer, pain patient


"Webequie is an isolated Ojibway community of about 800 people in Northern Ontario. It is 540
kilometres northwest of Thunder Bay, on an island in a lake. It is only accessible by air or a seasonal
winter road. The closest year-round road access is at Pickle Lake, 250 kilometres to the southwest.
The people of Webequie are standing together with the support of the community and regional
leadership to recover from the devastating impacts of widespread abuse of OxyContin® (oxy). Many
lives were deteriorating because of the misuse of these prescription pills. Finding a way forward
wasn’t easy. The challenges were a profound lack of funding and very little knowledge of what could
be done to help. So Webequie, along with other Matawa First Nations and the tribal council, set about
using shoestring budgets to provide direct community support.
Oxy pills were selling for $600 to 700 for an 80 milligram pill. These drugs led to robberies, break
and enters, and violence. There were some individuals who were so desperate for money that they
sold their appliances, furniture and TVs to feed their habit. Many children went hungry. Those on
drugs did anything for the money. Family violence was common.
As a community we suffered greatly, but were committed to finding a way forward. What we
recognize in our Ojibway worldview and way of life is that we should be asking ourselves what was
the way our ancestors saw; only then can we clearly see our way forward. First Nations substance
abuse is intertwined with the historical erosion of culture, intergenerational impacts of residential
schooling and other forms of emotional abuse, which caused deep trauma.
We realized we needed a customized approach to the prescription drug problem. We found about
70% of our population was involved with misuse of prescription drugs. As an isolated community, the
reality was that 100% of residents were impacted in some way by prescription drug harms.
The drugs resulted in deterioration of the kinship and values that define us as a people. The rise in
community safety issues was apparent. Kids were neglected and acted out at school. Bullying and
truancy became more evident. These drugs resulted in dysfunctional families, and mental and
emotional abuse. People would inject drugs and drop the needles where children could find them.
From 2011 to 2012, a Suboxone® trial was initiated by the Webequie First Nation. In total, 101 people
participated in the program, which was initially paid for by the community. The intent was to get
people off OxyContin. Participants did an initial induction for four to five days, and then were closely
supervised for a month. They then “maintained” after to prevent a relapse. At that time the doses
were tapered off.
We had counselling that included traditional and western approaches. People were able to access
traditional knowledge and medicine. Most were able to stay off oxy for a year after. We have one
doctor and community nurses living in Webequie year-round who are trusted. Addiction doctors fly
in as needed. People had the choice whether to combine traditional Anishinabe cleansing with
medical and non-medical detoxification. We are now on a journey towards a place of hope and
healing. The drug treatment program brought together Elders, and western and traditional medicine.
Those affected are healing. Parents are now playing with kids. Our community is much healthier than
a year ago and we have renewed hope. As indigenous people, our culture and spirituality offers
resilience. Our journey is not complete, but we are in a much better place and will continue to move

— Levis, a First Nation prescription drug awareness coordinator.

Conflict and Fragility.
 Do No Harm (click here)

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