Pubdate: Fri, 06 Nov 2015
Source: Windsor Star (CN ON)
Copyright: 2015 The Windsor Star
Contact:  http://www.canada.com/windsorstar/
Details: http://www.mapinc.org/media/501
Author: Jordan Westfall
Page: A8

DRUG POLICIES NEED REHAB MORE THAN CITIZENS DO

Economic circumstances often feed opioid abuse on the street, writes
Jordan Westfall.

In Ontario, someone dies of an opioid overdose every 14 hours. Most of
them are related to prescription opioids, which are often prescribed
for chronic pain.

With a reported 50 per cent of chronic pain patients facing wait times
of six months or more to see a qualified specialist, prescribed
opioids fill a health care gap.

Maybe this gap is the issue, and not the prescription that doctors are
using to fill it.

As many of the thousands of men and women who have lost their jobs in
the manufacturing sector could tell you, chronic pain doesn't
disappear when your job does.

We like to think of the people who use and sell drugs as criminals,
not laid off assembly line workers with chronic pain conditions and
reduced prospects.

The U of T's Mowat Centre estimates that Ontario has lost 300,000
manufacturing jobs since the year 2000. Many of these workers face an
uphill battle transitioning to new industries.

For some, selling all or a portion of their meds becomes income
replacement. A social assistance cheque for a single person provides
approximately $600 per month.

Let's say a chronic pain patient is prescribed 60 high dose oxycodone
(the generic form of OxyContin) tablets each month ranging in street
price between $20 and $40. Selling their entire prescription would
generate $1,200 to $2,400 in additional monthly income.

This is an example of how harsh economic conditions and a strained
healthcare system can influence the supply of the opioid drugs being
sold on Ontario's streets. And when times get tough, many turn to
drugs to cope.

In the Eastern European nations that comprised the former Soviet
Union, rates of injection drug use and HIV increased rapidly after the
fall of Communist rule.

Times have been tough for Southern Ontario in recent years, dealing
with job loss but also the environmental consequences of its
manufacturing sector.

The Windsor, Ontario neighbourhood that I grew up in is coming to
grips with a Cancer Care Ontario report that suggests it has a rate of
lung cancer more than double Ontario's provincial rate. The
neighbourhood in the report is located between several manufacturing
and industrial sites.

Each incidence of cancer in this neighbourhood has a story behind it,
and family members trying to cope.

Some cancer patients receive prescription opioids to deal with
chemotherapy related pain. While their family members turn to these
drugs to cope with economic circumstances that left them under or
unemployed and facing the additional burden of caring for sick family
members.

Fears of opioid abuse are understandable, but if we ignore their
economic and social context, we're overlooking the root causes of the
issue.

When this occurs, prescription opioids and the people that use them
become our focus, and criminalization occurs.

Take the 2012 OxyContin reformulation for instance. OxyContin was a
popularly prescribed drug, due in part to the influence of its
manufacturer, which was convicted of misleading the public about its
addictive potential. Afterward, the drug was reformulated to reduce
its abuse potential.

Nowadays, organized crime outfits have stepped in to reintroduce the
drug. It's still sold as OxyContin, but the active ingredient has changed.

Before the OxyContin reformulation, the drug was prescribed by doctors
and sometimes diverted to street markets by their patients.

Now, it's sold illicitly by people without any medical qualifications.
They don't swear to the Hippocratic Oath either.

It's no shock that the pills being sold aren't OxyContin at all, but
instead fentanyl, a drug 100 times more potent. Nor that Ontario has
more overdose fatalities than ever in its history.

Drug use is often described as being symptomatic of a bigger issue in
a person's life.

Why aren't we applying the same logic to our communities?

Jordan Westfall, is a policy analyst for the Canadian Drug Policy 
Coalition, based in Vancouver. He grew up in Windsor, Ontario.
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MAP posted-by: Matt