CCSA responds to commentary on prescription drug abuse

Rita Notarandrea
August 21, 2014
Written by Rita Notarandrea
As the Deputy CEO of the Canadian Centre on Substance Abuse (CCSA), I am compelled to respond to Dr. David Juurlink’s article, “Doctors inadvertently turning patients into addicts.” Compelled for two reasons. First, I am always grateful when the harms associated with prescription drugs such as opioids, stimulants, sedatives and tranquilizers are brought into the public forum. It is important for all Canadians to be aware of this issue, and to contribute to the ongoing dialogue. Second, while there are many points on which Dr. Juurlink and I agree, there are others related to CCSA and our work that require clarification.
I absolutely agree with Dr. Juurlink’s assertion that the harms associated with prescription drugs – addiction, overdose and death – are a public health and safety concern that has reached crisis proportions in Canada. I also agree with many of his recommendations to address these harms, including that doctors need enhanced education regarding pain and its treatment; that we need a comprehensive national assessment of the toll exacted by opioids; and that doctors and pharmacists should be better equipped to monitor patients’ medication profiles.

In fact, these recommendations are among the 58 that have been identified as priorities for action in First Do No Harm: Responding to Canada's Prescription Drug Crisis – a comprehensive 10-year, pan-Canadian strategy released by CCSA in March 2013, in partnership with the National Advisory Council on Prescription Drug Misuse.

However, I’d like to clarify the role of the Canadian Centre on Substance Abuse in the development and implementation of this Strategy.

At a National Dialogue on Prescription Drug Misuse in February 2012, diverse organizations with ownership in both the problem and finding solutions – including Health Canada – came together to discuss this emerging national concern. It was during this meeting that CCSA accepted a request from meeting participants to take the lead in developing and implementing a national strategy. However, the end product was very much born of collective action for collective impact.

And, with CCSA’s leadership, this collective commitment remains strong. The “volunteers” that Dr. Juurlink references are representatives of organizations that have a professional and/or mandated responsibility on this issue. CCSA brought together these organizations, which represent healthcare practitioners, regulators, patients and families, First Nations, law enforcement, the pharmaceutical industry, researchers and governments to develop and deliver on First Do No Harm. They all remain at the table, as important members of the implementation teams that are breathing life into the pages of First Do No Harm.

CCSA remains the backbone organization to lead this initiative and coordinate the work of the teams, who are bringing about real and positive change in areas such as prevention, education, treatment, enforcement, legislation and regulation, and monitoring and surveillance. In fact, their many accomplishments were recently highlighted in the inaugural First Do No Harm Annual Report.

In addition, federal, provincial and territorial Health Ministers have all prioritized and begun developing a national monitoring and surveillance system, which includes prescription monitoring.

Regarding these accomplishments, there is one final point on which I will agree with Dr. Juurlink. That is, much of this work was achieved with limited funding. On this, I am immensely proud of the work undertaken by CCSA staff and the many committed individuals and organizations that join us to reduce the harms associated with prescription drugs, while also giving important consideration to their therapeutic uses.

This being said, CCSA and our partners continue to pursue funding to support this significant undertaking. Of particular note is Health Canada’s recent Call for Proposals (under the Drug Strategy Community Initiatives Fund) to improve the prescribing practices for prescription drugs that have a high risk of abuse or addiction.

Just as importantly, we welcome the involvement of professionals such as Dr. Juurlink, who is clearly passionate about this issue and committed to reducing the harms associated with prescription drug misuse and abuse.

In closing, while action has been taken, there remains much more we can and must do. CCSA looks forward to continuing its contributions alongside our many committed partners to achieve greater collective impact. We invite governments at all levels to join us. And I will be sending Dr. Juurlink a personal invitation to join the work being done to promote the health of individuals and families, and create safer communities across Canada.

Rita Notarandrea
Deputy Chief Executive Officer
Canadian Centre on Substance Abuse

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