TORONTO, Nov. 24, 2011 /CNW/ - A new study has shown harmful
prescription patterns of powerful painkillers among a substantial
number of Ontario patients who received methadone therapy to treat
their opioid addiction.
Methadone, which is a type of long-acting opioid, has proven to be an
effective therapy for opioid dependence.
According to a new study by the Centre for Addiction and Mental Health
(CAMH) and Institute for Clinical Evaluative Sciences (ICES), 18% of
methadone maintenance therapy patients also received prescriptions for
more than a week's supply of other opioids.
"It is concerning when large quantities of these types of opioids are
combined with methadone therapy, as it can lead to overdose or fatal
consequences," says Dr. Paul Kurdyak, head of CAMH's Emergency Crisis
Services and Research.
The study is published online in the journal Addiction. It should be noted that these data were collected before the
Government of Ontario announced its narcotics strategy. The strategy
includes improved monitoring of narcotics prescribing which took effect
November 1 2011.
On average, this group of methadone patients had 12 non-methadone opioid
prescriptions a year during a seven-year period from 2003-2010. In
addition, nearly half (46%) of the non-methadone opioid prescriptions
were from physicians and pharmacies that were not involved in
prescribing and monitoring methadone use.
"If someone on methadone maintenance therapy needs pain management, they
should be prescribed short-acting opioids for short periods of time,
and these prescriptions should be written by the methadone prescriber
so that the patients can be monitored," says Dr. Kurdyak, adjunct
scientist at ICES and assistant professor of medicine at the University
Opioid prescriptions and related overdoses and deaths have increased
dramatically in recent years in North America. Recent research has
suggested that the cause of many methadone-related deaths could be the
use of non-methadone opioids.
The researchers used the Ontario Drug Benefit (ODB) database to identify
prescription records for methadone and other opioids, and examined
opioid prescription patterns among 18,759 people who received methadone
"People taking methadone should not be taking other opioids for extended
periods. The fact that we're seeing this happen in nearly one in five
cases, coupled with the observation that multiple doctors and
pharmacies are often involved suggests that, in some instances at
least, patients in methadone treatment programs are deceiving doctors
to obtain other opioids," says Dr. David Juurlink, co-author of the
study and ICES scientist.
Because patients on methadone therapy undergo random urine tests - and
could face consequences if additional opioids are found in their system
- it is also possible that these prescriptions are being sold
"One remedy to this problem is a prescription monitoring system that
allows pharmacies to communicate in real time, similar to what British
Columbia implemented in the mid-1990s," says Juurlink. "Had such a
system been in place in Ontario, I imagine that our findings might have
been very different."
Since the study was carried out, Ontario has enacted the Narcotics Safety and Awareness Act to balance the need to access and prescribe monitored drugs
appropriately for pain management, while reducing the abuse, misuse and
diversion to the illicit market.
In 2010, the Canadian Guideline for Safe and Effective Use of Opioids for Chronic
Non-Cancer Pain was developed as a guide for Canadian physicians and pharmacists for the
SOURCE Centre for Addiction and Mental Health
For further information:
CAMH Media Relations
Media Advisor, ICES