By Phil Gibson. Tory Health Minister Panicked about Wrong Drug Crisis
Lost in Conservative clucking over heroin is a serious spike in prescription painkiller deaths.
Published on The Tyee.ca, 7 Oct 2013, Originally published on iPolitics
Photo: Rona Ambrose ‘I did what now …’
A minister in a new portfolio has one chance to make a first impression. Rona Ambrose had her chance last month. The tone she set on drug policy is less than inspiring. “Our policy is to take heroin out of the hands of addicts, not put it into their arms,” the ministerprimly declared in September when she ordered Health Canada to respect “the spirit and intent” of the Special Access Programme. The program was designed to treat exceptional cases and medical emergencies, she said, not as a back door for addiction treatment staff to access heroin.
Although sounding a punitive and judgmental note as she overruled her officials, Ambrose was merely upholding the status quo in a debate over treatment alternatives.
After she whipped her bureaucrats into line, Conservative opportunists stained the new minister’s reputation by sending a fundraising email to party sympathizers asking for money. Connecting these dots, donors might think their contributions would be used to battle drug abuse. That would be naive.
“Drugs like heroin tear families apart, promote criminal behaviour and destroy lives,” the email said, softening a calculated pitch with sentiment.
True enough. But the Special Access Programme is designed to give treatment specialists alternatives in their effort to wean addicts off their drugs.
By exploiting the situation, Conservative party operatives confused established treatment methods with illicit procurement. By fronting their tactics, Ambrose appeared to brush aside the expertise of professionals in another moralistic instance of single-minded ideology run amok.
When dogma guides policy
The neophyte minister may want to reset her public image. If she does, she could win some support by tackling the growing epidemic of accidental deaths from prescription medications.
Overdoses of pain medication are now killing more people in North America than automobiles, according to physicians and medical researchers who are trying to manage the problem.
This growing crisis is ripping loved ones from their families. Its victims represent a growing cross-section of the voting public, a constituency which, like mothers against drunk driving and victims of crime, may be more powerful than anyone has recognized until now.
The Harper government likes to have a free hand in setting policy on such matters. The cancellation of Statistics Canada’s mandatory long-form census, climate change skepticism and a general lack of enthusiasm for science are just a few reasons to conclude the Harperites prefer dogma to evidence as a basis for policy decisions.
They also have a record of electoral success through locating and targeting unexploited voting blocs. At the risk of sounding cynical, maybe this epidemic could be a political opportunity.
Health Canada is not engaged in the management of the opioid epidemic, so there are no reliable national statistics on the extent of the problem. For the same reason, there is no national database to monitor prescribing practices across provincial boundaries.
Fed up with federal inaction
Canadians exasperated with their government’s inaction on the use and misuse of prescription painkillers were in Washington this week to join a rally on Capitol Hill. Families of victims and physicians concerned about the epidemic are convinced that federal coordination is essential if an upturn in the number of fatalities is going to be reversed.
Personal grief motivates many activists. Mississauga’s Donna May lost her 34-year-old daughter last year after a lengthy ordeal of addiction, hospitalization, treatment and overdose.
May was in Ottawa this week to speak at an event organized to campaign for a supervised injection site there. In an interview, she said that the experience with her daughter convinced her that addiction is a sickness — and that addicts need the full range of treatment options.
The experience caused her to mount her own organization, which she calls Jac’s Voice.
“The one opportunity my daughter’s experience has given me is to be her voice.”
Of the health minister she said: “I wonder if she’s not just saying what she’s mandated to say. I wonder what’s really in her heart.”
She and other concerned Canadians are talking about a rally of their own next year. A spike in deaths by overdose in this country prompted several to support the Fed Up Rally in Washington. Supporters believe that there is no time to waste in the campaign against drug manufacturers who underestimate the dangers of using their products and hype the benefits.
The drug approval process, randomized control trials, research, requirements for warning labels and industry marketing are responsibilities of Health Canada, which is not engaged in managing the epidemic.
“This man-made epidemic… is a result of drug manufacturers providing incomplete and inaccurate information about the dangers of opioids to everyone who plays a role in our health care system,” says Ada Giudice-Tompson, vice-president of Advocates for the Reform of Prescription Opioids, a citizens’ group urging federal action. Prescribing advice on labels is so broad that the drugs can be marketed for inappropriate uses, according to watchdog groups.
“The label is supposed to reflect uses for the drug that have been tested and are based on sound evidence,” said Giudice-Tompson in a recent email. That is “not the case for the widespread use of opioids long-term, for chronic non-cancer pain.”
She says confusion between legitimate pain management and abuse by addicts is adding to the momentum of the epidemic because manufacturers and policy-makers can dismiss the problem as a consequence of personal choice.
The cynical ploy by Conservative fundraisers over heroin use has done little to encourage the Canadian campaigners to relax their vigil.
