Access to New Treatment is Needed to Manage Prescription Painkiller
Dependence Without Risk of Overdose or Misuse
KIRKLAND, QC, Sept. 3 /CNW/ - Prescription painkiller dependence is a
serious problem in Ontario, according to the results of a new survey conducted
by Léger Marketing polling 211 Ontario General Practitioners. The survey
reports that the majority of Ontario physicians (84%) feel that their patients
may be addicted to commonly-prescribed painkillers (i.e., opioid-based such as
oxycodone, morphine, meperidine and acetaminophen-codeine)(1).
"Prescription opioid dependence is a growing health concern in Ontario,"
said Donnie Edwards, Port Colborne Community Pharmacist and Certified Drugs of
Addiction Expert. "I have seen first-hand how this type of dependency can
affect many aspects of a person's life including marriage, friendships,
employment, financial standing and judgment, whereby personal safety becomes
secondary to the need to obtain opioid-based drugs."
"As a front-line health care provider specializing in drugs of addiction,
my hope is for better access to treatments that will benefit Canadians who
suffer from opioid dependence," added Edwards. "It's important to have new
choices. Arming health care providers with another weapon in the fight against
opioid dependence will serve to help patients manage this disease."
Dr. Joel Bordman, Medical Director of the Complex Pain Program at First
Step Medical Clinics said, "As a physician working with opioid dependent
patients, I am well aware of the current trend of opioid abuse. There is a
need for a new, safe and effective substitution treatment that lowers the
potential for misuse and overdose, while providing patients who are dependent
on opioids the opportunity to manage their symptoms, take control of their
lives, and stay on the road to recovery."
Available in Canada since the end of 2007, SUBOXONE(R) (buprenorphine /
naloxone) is the first new treatment for opioid dependent patients in over 30
years(2), suppressing the symptoms of opioid withdrawal, reducing the cravings
for opioid drugs(3), and designed to deter misuse. However, SUBOXONE is not
widely accessible to patients in Ontario at this time.
SUBOXONE combines buprenorphine with naloxone. Buprenorphine, a partial
opioid agonist, helps manage the cravings associated with opioid
withdrawal(6). The naloxone component of SUBOXONE reduces the potential for
misuse by causing unpleasant withdrawal symptoms if the product is misused by
intravenous injection by an opioid dependent person(4). SUBOXONE has a
'ceiling' effect, whereby its physiological effects level off at a certain
point, even at higher doses(5). Treatment may include take-home doses after a
period of two months, based upon an assessment of the patient's clinical
stability and their ability to safely store the product at home(9).
People use opioid-based medications to manage pain. The vast majority use
their opioid medications properly and benefit from reduced pain and improved
quality of life. However, some people have a predisposition for addiction and
may become opioid-dependent, although it is not because of a lack of morals or
willpower(6). Treating opioid dependence offers many medical and personal
benefits to patients, their families and society as a whole(7). Unfortunately,
there are a limited number of treatments and a limited number of physicians
who can prescribe them.
In Ontario, approximately 30,000 people regularly use illegal opioids,
most of which are diverted from the medical system. Just over half of these
individuals receive treatment(8). Over the last decade, there has been an
increase in illicit drug users abusing prescription opioid drugs(9).
Symptoms of opioid dependence observed by Ontario physicians include
using more than intended (96%), needing a higher dose to obtain the same
effect (91%), being unsuccessful at cutting back (86%), experiencing
withdrawal when not taking any medication (82%), and compulsive use despite
harm (59%). Requests for additional medications are also common, with
74 per cent of physicians often or occasionally receiving requests for
additional opioid prescriptions because their patients have lost their
prescriptions or need early refills(1).
Ninety-four per cent of Ontario physicians polled consider drug
substitution therapy to be beneficial and 82 per cent feel that it helps break
the dependency cycle, allowing patients to regain control of their lives(1).
Although methadone is the most commonly prescribed drug substitution therapy
for those who are dependent on opioids(1), Ontario physicians are somewhat
concerned with the potential for misuse (63%), overdose (62%), and the
possibility of combining it with other illicit opioids (60%)(1).
Approved by Health Canada in May, 2007(9), SUBOXONE is indicated for
substitution treatment of opioid drug dependence in adults. The intention of
the naloxone component is to deter intravenous misuse. Patients prescribed
SUBOXONE should be carefully monitored within a framework of medical, social
and psychological support as part of a comprehensive opioid dependence
treatment program(9). The approval of this drug is based on results of a
four-week safety/efficacy study in 326 subjects with a maximum daily dose of
16 mg and a 48-week open-label safety study involving 461 patients(10).
SUBOXONE is taken once a day as a sublingual tablet placed under the tongue to
To help ensure appropriate use of SUBOXONE, Schering-Plough Canada is
also offering an online education program for health care professionals,
accredited by The College of Family Physicians of Canada. The program provides
professionals with information needed for product use, supporting the dialogue
between patient and physician about the risk and benefits of therapy. It also
encourages an approach to care involving the careful monitoring of patients
within a framework of medical, social and psychological support as part of a
comprehensive opioid dependence treatment program.
Schering-Plough Canada is dedicated to improving patient access to
treatment for this disease. SUBOXONE should only be prescribed by physicians
who have experience in the substitution treatment in opioid drug dependence,
and have completed an accredited SUBOXONE Education Program. Physicians can
obtain more information about the SUBOXONE Education Program by calling
1-800-463-5442 or visiting www.SUBOXONECME.ca(9).
Schering-Plough is an innovation-driven, science-centered global health
care company. Through its own biopharmaceutical research and collaborations
with partners, Schering-Plough creates therapies that help save and improve
lives around the world. The company applies its research-and-development
platform to human prescription and consumer products as well as to animal
health products. Schering-Plough's vision is to "Earn Trust, Every Day" with
the doctors, patients, customers and other stakeholders served by its
colleagues around the world. The company is based in Kenilworth, N.J., and its
Web site is www.schering-plough.com.
SUBOXONE(R) is a registered trademark of Reckitt-Benckiser Healthcare
(UK) Limited, used under license by Schering-Plough Canada Inc.
(C) 2008, Schering-Plough Canada Inc. All rights reserved.
(1) Leger Marketing. Opioid Dependence in Ontario.
(2) Best Practices: Methadone Maintenance Treatment. Health Canada Web
site. Available at:
(3) Buprenorphine Sublingual and Buprenorphine and Naloxone Sublingual.
Medline Plus Web site. Available at:
Accessed Oct. 3, 2007.
(4) Subutex and Suboxone Approved to Treat Opiate Dependence. U.S. Food
and Drug Administration Web site. Available at:
July 27, 2007.
(5) SUBOXONE(R) (buprenorphine / naloxone) Product Monograph, Schering-
Plough Canada Inc.; May 2007
(6) Opioid Addiction. National Alliance of Advocates for Buprenorphine
Treatment. Web site. Available at:
July 24, 2007
(7) Research report series - prescription drugs: abuse and addiction.
National Institute on Drug Abuse Web site. Available at:
Accessed August 22, 2007.
(8) Report of the Methadone Maintenance Treatment Practices Task Force.
W.Anton Hart ,Chair, March 2007
(9) Haydon E, Rehm J, Fischer B, et al. Prescription drug abuse in
Canada and the diversion of prescription drugs into the illicit drug
market (Commentary). Can J Public Health 2005;96(6):459-61
(10) Fudala PJ, Bridge TP, Herbert S, et al. Office-based treatment of
opiate addiction with a sublingual-tablet formulation of
buprenorphine and naloxone. N Engl J Med 2003;349:949-58.
For further information:
For further information: Media Contacts: Mona Aubin, Schering-Plough
Canada, (514) 428-8833, email@example.com; Collin Matanowitsch, Manning
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