Wednesday, February 29, 2012

Doctors Don't Always Get to Bury Their Mistakes

One question - who allowed this to happen?  "This" is the oxycontin addiction plague that has swept through northern native communities and may leave enormous suffering in its wake when the drug is abruptly removed from distribution next month.  Oxycontin, the so-called "hillbilly heroin", drug of choice of addicts like Rush Limbaugh.

It is reported that some northern communities have oxycontin addiction rates in excess of 50% of the population.   Imagine half a village facing opioid withdrawal at once.

Getting doctors to prescribe opioids more appropriately needs to be part of the solution, because many of them may just unwittingly switch their patients to other equally addictive drugs, such as hydromorph contin, fentanyl or morphine, said [Dr. Meldon Kahan, medical director of addiction medicine service at St. Joseph’s Health Centre in Toronto] .

Hydromorph contin, for example, provides a sustained release of hydromorphone, which like OxyContin can be crushed, injected and is fully covered under the Ontario drug benefit plan. 

“This is a very unusual public health crisis because it was generated by the medical system,” said Kahan. “Doctors' knowledge of this is not very high, because they don’t get much training on it.”

Say what?   Don't these doctors read newspapers or watch shows like 60 Minutes that has run exposes on OxyContin abuse?  If the general public knows the perils of this drug any doctor who claims he doesn't is either incompetent or a liar.

Affixing blame is necessary to prevent this happening again.  It's part of fixing a system that is very plainly broken.   That said, someone has to take responsibility for the addiction nightmare that will be sweeping the north in just a few weeks.  If we have any claim to being a civilized society, we just cannot leave these addicts to their fate.

Maybe it's time the medical profession took responsibility for the failure of its own members.   They want to be a self-governing profession.   That privilege comes with responsibilities to society including overseeing the standards of practice and the continuing education of members.   It was members of the medical profession who earned fees writing these prescriptions and we expected them to act responsibly when we granted them that authority.   A good many of them obviously abused that privilege and now they and the profession that failed to regulate them should make good the suffering in the north.


Anonymous said...

So, cigarette manufacturers distributed an addictive product, and goverments and individuals sued them for the damages. Is this happening to the manufacturers of oxycontin? Is the govt suing for damages? Does the middle man "doctor" make the product LESS of a harmful substance and mean the pharma co is not responsible for the product? I don't think so.

The Mound of Sound said...

There is probably no end of prescription medications that are addictive and harmful if abused. That's why we make them available only by prescription and why we authorize only medical professionals to issue prescriptions. That makes physicians the portal for oxycontin access and they're paid to operate and safeguard that portal. They're the gatekeepers, a function they have chosen for themselves and for neglect of which liability should attach.

Yes, the middle man "doctor" you refer to is required to make the product less harmful by restricting access to it except as required and under medical supervision. Whether pharmacies should have some responsibility also is an interesting question. It would seem quite conceivable that, with addiction levels of this magnitude, there must have been a limited number of pharmacies processing a heavy number of prescriptions.

Today we're getting into computer systems that can detect prescription drug abuse, by patient and by physician. This is key to prevent substance abusers from making the rounds of doctors' offices to garner multiple prescriptions.

sassy said...
This comment has been removed by the author.
sassy said...

That was me above (typo)

Oxycontin is a(about to be a was) legal drug.

Aside from who is to blame, what the hell is wrong with the yahoos (the old meaning of yahoo, not the internet one) who have decided to take it off the market without providing sufficient support services for those who are addicted and face withdrawal.

1:01 PM, February 29, 2012

The Mound of Sound said...

I totally agree, Sassy. It's as though nobody bothered with the addiction problem, perhaps because it's largely (it seems) in First Nations' villages.

From what I've read about this situation elsewhere, it's an open invitation to heroin and opium pushers who don't wait to exploit a ready-made addict market.

The Mound of Sound said...

Actually I meant "heroin and morphine" pushers.