By Meghan Potkins, Calgary Herald
- While most major oil and construction industry employers already employ some form of testing, DARRPP is hoping the pilot project will demonstrate that random testing programs can be a significant deterrent to substance abuse in the workplace.
An independent group set up to study drug screening practices in the energy sector announced Wednesday details of a project that could see thousands of workers subject to random workplace testing as early as this fall.
The Drug and Alcohol Risk Reduction Pilot Project says participating companies will begin the pilot program in late 2012 and 2013.
Suncor Energy, Total E&P Canada and Canadian Natural Resources Ltd. are the first to have signed on.
While most major oil companies already use some form of drug screening, DARRPP is hoping to prove that random testing can be a significant deterrent to substance abuse in the workplace.
“We’re still seeing quite a few positive tests. We’re also seeing people coming to work with risky behaviours that aren’t appropriate … and it poses serious risks to the individuals involved, their co-workers, families and communities,” said DARRPP administrator Pat Atkins.
Suncor said it will begin random tests of employees in safety-sensitive jobs beginning in October.
The oil giant has hired substance abuse professionals for its Fort McMurray operations and is preparing to use a third-party service to monitor the testing program.
“We have identified pressing workplace safety concerns in the Wood Buffalo region related to alcohol and drugs,” said a company spokesperson. “(Random testing) is necessary just to make sure that workers go home safely to their families at the end of shift.”
In 2008, the Alberta Court of Appeal upheld the right of employers to implement alcohol and drug testing policies.
But civil rights defenders say random tests raise all sorts of difficulties when it comes to the rights and privacy of workers.
Random testing can be considered discriminatory if it isn’t justified, said Linda McKay-Panos of the Alberta Civil Liberties Research Centre.
Even justified testing can pose problems, says McKay-Panos, especially since traditional test methods are not foolproof and innocent workers are occasionally ensnared by inaccurate screening devices.
“It’s inaccurate, invasive and it violates the trust between employers and employees. There must be a different way to address the issue,” she said.
Calgary-based Cenovus Energy says it has a policy of testing employees in safety-sensitive jobs before they are hired.
“But (testing) isn’t randomly done otherwise throughout their employment,” said spokeswoman Rhona DelFrari.
“We do have a zero tolerance for people being under the influence of drugs at work. If anyone is suspected of being under the influence of drugs or alcohol at work, that staff member can be reported to a supervisor and that staff member will be immediately investigated.”
DARRPP says that practices like this are not as effective as they could be at identifying at-risk workers before an accident happens.
The group points to industry data showing that close to six times more alcohol and drug abuse problems are revealed in substance abuse assessments after an incident occurs than in pre-emptive tests prompted by supervisor observations.
But at least those simple observation are less invasive and much less costly, contends labour advocate Gil McGowan.
“It’s an unreasonable invasion of a worker’s privacy, and in many cases we believe these kind of regimes contravene human rights legislation,” said the Alberta Federation of Labour president.
DARRPP represents a group of industry associations and energy and construction sector companies, including: Building and Construction Trades Canada, the Christian Labour Association of Canada, the Oil Sands Safety Association, Construction Labour Relations (Alberta), the Progressive Contractors Association of Canada and the Construction Owners Association of Alberta.
The group says it will release the results of the pilot program in 2014 and that data gathered over the next two years will be used to build a framework for drug screening in the industry.
By Mark Elliot - What would happen if we won the war on drugs?
What if we could deal successfully with the problems of addiction with treatment and see the tangible evidence of success in lower crime rates?
We only need to look at Washington D.C. in 1972 to have a sense of might have been. You wouldn’t necessarily connect Richard Nixon and drug-legalization, but the biggest advance in drug treatment, the legalization of the opiate drug, methadone, for use as a “maintenance medicine” in treating heroin addiction, began during his term of office.
This month, a new opiate, buprenorphine, for treating heroin addiction has been introduced with a lot of fanfare. And still, no one has said “Happy Thirtieth Birthday” to methadone. Even the man responsible for methadone’s legalization in 1972, Dr. Robert Dupont, told PBS Frontline: “Methadone was just horrible from a political point of view, just a total disaster. It was an orphan from beginning to end, and it is today.”
Before Ecstasy, crack cocaine, LSD, or even pot were common, the scourge of heroin was the nightmare.
Heroin held inner cities captive and desperate and this resulted in criminal activity.
It was in the late 60s when Dupont ran studies on prison inmates in Washington D.C. that revealed the link between heroin and crime. With urine cups in hand, he and a team of young researchers tested prisoners for one month and found that 44% tested positive for heroin. As Dupont recollected, “Nixon had promised to do something about rising crime rates and the most embarrassing thing of all was the rate of crime in Washington D.C.” By introducing a methadone treatment program, Dupont was able to treat the addicts and D.C. crime rates dropped a whopping 50% - enough to get him the attention of the White House, and the appointment as U.S. Drug Czar. Nixon told Dupont that he would back him on anything promising if he didn’t try to legalize marijuana.
“I didn’t come out in favor of marijuana,” Dupont said. “I legalized methadone.”
According to Dupont: “The search for medicines to treat addictions for the most part has not been very helpful. If the alternatives are active heroin addiction and criminal behavior versus getting methadone or buprenorphine from a clinic, I think the answer is very clearly that methadone or buprenorphine is better.
I’d like to think that the alternative should be to be drug free, but the question is: How realistic is that for a lot of heroin addicts?” So was the introduction of methadone treatment valuable? “I think it was a good thing.
It’s hard to imagine today that in 1970 ‘the drug problem’ was ‘the heroin problem.’”
That’s not the case today because so many other drugs have become as big or even bigger problems, but in 1970 ‘addiction’ meant ‘heroin addiction.’ “Initially the drug problem was approached entirely as a law enforcement problem and it was in the Nixon administration that for the first time a presidential administration made a significant commitment to treatment…”
Dupont continued: “I don’t think Nixon was particularly drawn to the idea of methadone or treatment at all. The issue was that he was the president at that time when the country was facing the epidemic of heroin addiction, and the right thing to do was to add treatment as a major component of his program. And he did that even though that didn’t fit with his politics.”
Dupont added, however, that “there are problems with methadone which I don’t think were obvious to anybody at the time.” One had to do with diversion of methadone to the streets where it is also a drug of abuse. Also, overdose deaths. “So, methadone became a major contributor to overdose deaths on the streets, which I certainly did not foresee at the beginning.”
Dupont noted that drug diversion from legitimate use is a huge problem today. “I think it’s also going to be a problem with buprenorphine.”
So what happened to the massive crime reduction in Washington with the introduction of methadone?
“That’s the sad story of what happens when you succeed,” said Dupont. In short, people walked away from what had been accomplished and the crime rate rose.
“I’ve had some thoughts since then that when you are successful in this field, it’s almost worse than when you fail, because when you are successful nobody cares about it anymore.”
crazy weekend! Lots to do.. and so much time on the phones with individuals
that are in incredible denial.. it is scary! I am guilty of believing that I am
going to be here on this earth in the next hour… next day, next year…
reality is no one really knows for sure…. and when you are playing Russian
roulette, the reality is that we are even more unsure of this… YET people in
denial and at risk think they have all the time in the world…. blows my mind.
I worry and pray for them and those around them.
Tammy Francoeur, Director of Peer Support
The psychiatric profession is ignoring evidence that treatment with antipsychotics can be harmful, according to a new book
- guardian.co.uk, Sunday 2 March 2008 12.00 GMT
- Article history
Christian was slouched in a chair in Bradford psychiatric unit. He was, seemingly, only half-conscious, half alive. He could hardly speak, let alone raise his head. Christian had been diagnosed with schizophrenia. Two days before, in a haze of paranoia, he had punched a colleague of mine at a day centre. So Christian was sectioned and medicated, heavily, with neuroleptic drugs.
Most people, on seeing Christian, would have described him as being so whacked out he was a dribbling wreck. The drug-advisory body, the National Institute of Health and Clinical Excellence (Nice) would say the neuroleptic treatment had successfully “calmed” Christian, in preparation for treating the “underlying psychiatric condition”.
Neuroleptics - such as Clozapine, Olanzapine, Risperidone and Seroquel - are the “primary treatment” for psychosis, particularly schizophrenia. Indeed, 98%-100% of people diagnosed with schizophrenia inside our psychiatric units - and 90% living in the community - are on neuroleptics, also called antipsychotics. Nice’s guidelines for the treatment of schizophrenia say: “There is well established evidence for the efficacy of antipsychotic drugs.”
A similar efficacy used to be claimed for Prozac and other SSRIs in the treatment of depression. But a study published last Tuesday could well have pulled the plug on Prozac.
And now a London NHS psychiatrist, Joanna Moncrieff, has similarly endeavoured to expose the “myth” of antipsychotics. Whereas Moncrieff has already highlighted antidepressant non-effectiveness, it is her research on antipsychotics that is more shocking. The evidence shows, she says, that antipsychotics not only do not work long-term they also cause brain damage - a fact which is being “fatally” overlooked. Plus, because of a cocktail of vicious side-effects, antipsychotics almost triple a person’s risk of dying prematurely.
Moncrieff particularly strikes out at her own profession, psychiatry, claiming it is ignoring the negative evidence for antipsychotics. In her book, The Myth of The Chemical Cure, Moncrieff argues, effectively, that psychiatry is guilty of gross scientific misconduct.
Having examined decades of clinical trials, Moncrieff’s first point is that once variables such as placebo and drug withdrawal effects are accounted for, there is no concrete evidence for antipsychotic long-term effectiveness. This is a radically different interpretation of the meta-analyses and trials Nice used to arrive at its opposite conclusion. But Moncrieff is confident her scrutiny of the evidence is valid.
At the heart of years of dissent against psychiatry through the ages has been its use of drugs, particularly antipsychotics, to treat distress. Do such drugs actually target any “psychiatric condition”? Or are they chemical control - a socially-useful reduction of the paranoid, deluded, distressed, bizarre and odd into semi-vegetative zombies?
Historically, whatever dissenters thought has been ignored. So, it appears, have new studies which indicate that antipsychotics do not work long-term. For example, a US study last year in the Journal of Nervous and Mental Disease reported that people diagnosed with schizophrenia and not taking antipsychotics are more likely to recover than those on the drugs. The study was on 145 patients, and researchers reported that, after 15 years, 65% of patients on antipsychotics were psychotic, whereas only 28% of those not on medication were psychotic. A staggering finding, surely? So where were the mainstream media yelps of “breakthrough in schizophrenia treatment”. Not a squeak.
Moncrieff’s second point is that the psychiatric establishment, underpinned by the pharmaceutical industry, has glossed over studies showing that antipsychotics cause extensive damage - the most startling being permanent brain atrophy (brain damage) or tardive dyskinesia. As in Parkinson’s Disease, patients suffer involuntary, repetitive movements, memory loss and behaviour changes. Antipsychotics cause atrophy within a year, Moncrieff says. She accuses her colleagues of risking creating an “epidemic of iatrogenic brain damage”.
Moncrieff is a hard-nosed scientist, so she is respectfully reserved. But gross scientific misconduct is her accusation. “It is as if the psychiatric community can not bear to acknowledge its own published findings,” she writes.
How worrying it is, then that the Healthcare Commission should report last year that almost 40% of people with psychosis are on levels of antipsychotics exceeding recommended limits. Such levels cause heart attacks. Indeed, the National Patient Safety Agency claims heart failure from antipsychotics is a likely cause for some of the 40 average annual “unexplained” deaths of patients on British mental health wards. Other effects of antipsychotics include massive weight gain (metabolic impairment) and increased risk of diabetes.
Two years ago, The British Journal of Psychiatry - Britain’s most respected psychiatry journal - published a study reporting that people on antipsychotics were 2.5 times more likely to die prematurely. The researchers warned there was an “urgent need” to investigate whether this was due to antipsychotics. But so ingrained is the medication culture in mental health that many psychiatrists feel that not medicating early with antipsychotics amounts to negligence, Moncrieff notes.
Moncrieff does acknowledge there is evidence for the short-term effectiveness of antipsychotics. But again Moncrieff asks psychiatry to be honest. Moncrieff points out that when antipsychotics, such as chlorpromazine, were first used in the 1950s they were “major tranquillisers”. Why? Because that’s an accurate description of their effect, particularly short term. They sedate, or tranquillise, the emotions, so reducing the anxiety of paranoia and delusions. Any person on antipsychotics is likely to verify this (go to askapatient.com). Now, however, these drugs are referred to as “antipsychotics”. For Moncrieff, this is a wheeze because there’s no evidence that antipsychotics act directly on the “symptoms” - paranoia, delusions, hallucinations - of those diagnosed with psychosis. There’s nothing antipsychotic about antipsychotics.
So what are the alternatives? Moncrieff - like her fellow psychiatrists in a group called the Critical Psychiatry Network - asks services to look seriously at non-drug approaches, such as the Soteria Network in America. She believes psychiatrists such as herself should no longer have unparalleled powers to forcibly detain and treat patients. Instead, they should be “pharmaceutical advisers” engaging in “democratic drug treatment” with patients.
Psychiatrists should be involved in “shared decision-making” with patients, and would have to go to civil courts to argue their case for compulsory treatment. “Psychiatry would be a more modest enterprise,” writes Moncrieff, “no longer claiming to be able to alter the underlying course of psychological disturbance, but thereby avoiding some of the damage associated with the untrammelled use of imaginary chemical cures.”
The mental health establishment should learn from the Prozac story and pay attention. It’s about time
Some anti-depressant drugs are associated with an increased chance of developing cataracts, according to a new statistical study by researchers at the University of British Columbia, Vancouver Coastal Health Research Institute and McGill University.
The study, based on a database of more than 200,000 Quebec residents aged 65 and older, showed statistical relationships between a diagnosis of cataracts or cataract surgery and the class of drugs called selective serotonin reuptake inhibitors (SSRIs), as well as between cataracts and specific drugs within that class.
Published online today in the journal Ophthalmology, the study does not prove causation but only reveals an association between the use of SSRIs and the development of cataracts. The study could not account for the possibility of smoking - which is a risk factor for cataracts - and additional population-based studies are needed to confirm these findings, the researchers say.
This study of statistical relationships is the first to establish a link between this class of drugs and cataracts in humans. Previous studies in animal models had demonstrated that SSRIs could increase the likelihood of developing the condition.
“When you look at the trade-offs of these drugs, the benefits of treating depression - which can be life-threatening - still outweigh the risk of
developing cataracts, which are treatable and relatively benign,” says Dr. Mahyar Etminan, lead author of the article, a scientist and clinical pharmacist at the Centre for Clinical Epidemiology at Vancouver Coastal Health Research Institute and an assistant professor in the Dept. of Medicine at UBC.
Researchers found patients taking SSRIs were overall 15 per cent more likely to be diagnosed with cataracts or to have cataract surgery.
The degree of risk among specific and different types of SSRIs varied considerably. Taking fluvoxamine (Luvox) led to a 51 per cent higher chance of having cataract surgery, and venlafaxine (Effexor) carried a 34 per cent higher risk. No connection could be made between fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft) and having cataract surgery.
Co-author Dr. Frederick S. Mikelberg, professor and head of the Dept. of Ophthalmology and Visual Sciences at UBC and head of the Dept. of Ophthalmology at Vancouver General Hospital, notes that the average time to develop cataracts while taking SSRIs was almost two years.
“While these results are surprising, and might inform the choices of psychiatrists when prescribing SSRIs for their patients, they should not be cause for alarm among people taking these medications,” Mikelberg says.
Provided by University of British Columbia (news : web)
Patients who use anti-depressants are much more likely to suffer relapses of major depression than those who use no medication at all, concludes a McMaster researcher.
In a paper that is likely to ignite new controversy in the hotly debated field of depression and medication, evolutionary psychologist Paul Andrews concludes that patients who have used anti-depressant medications can be nearly twice as susceptible to future episodes of major depression.
Andrews, an assistant professor in the Department of Psychology, Neuroscience & Behaviour, is the lead author of a new paper in the journal Frontiers of Psychology.
The meta-analysis suggests that people who have not been taking any medication are at a 25 per cent risk of relapse, compared to 42 per cent or higher for those who have taken and gone off an anti-depressant.
Andrews and his colleagues studied dozens of previously published studies to compare outcomes for patients who used anti-depressants compared to those who used placebos.
They analyzed research on subjects who started on medications and were switched to placebos, subjects who were administered placebos throughout their treatment, and subjects who continued to take medication throughout their course of treatment.
Andrews says anti-depressants interfere with the brain’s natural self-regulation of serotonin and other neurotransmitters, and that the brain can overcorrect once medication is suspended, triggering new depression.
Though there are several forms of anti-depressants, all of them disturb the brain’s natural regulatory mechanisms, which he compares to putting a weight on a spring. The brain, like the spring, pushes back against the weight. Going off antidepressant drugs is like removing the weight from the spring, leaving the person at increased risk of depression when the brain, like the compressed spring, shoots out before retracting to its resting state.
“We found that the more these drugs affect serotonin and other neurotransmitters in your brain — and that’s what they’re supposed to do — the greater your risk of relapse once you stop taking them,” Andrews says. “All these drugs do reduce symptoms, probably to some degree, in the short-term. The trick is what happens in the long term. Our results suggest that when you try to go off the drugs, depression will bounce back. This can leave people stuck in a cycle where they need to keep taking anti-depressants to prevent a return of symptoms.”
Andrews believes depression may actually be a natural and beneficial — though painful
– state in which the brain is working to cope with stress.
“There’s a lot of debate about whether or not depression is truly a disorder, as most clinicians and the majority of the psychiatric establishment believe, or whether it’s an evolved adaptation that does something useful,” he says.
Longitudinal studies cited in the paper show that more than 40 per cent of the population may experience major depression at some point in their lives.
Most depressive episodes are triggered by traumatic events such as the death of a loved one, the end of a relationship or the loss of a job. Andrews says the brain may blunt other functions such as appetite, sex drive, sleep and social connectivity, to focus its effort on coping with the traumatic event.
Just as the body uses fever to fight infection, he believes the brain may also be using depression to fight unusual stress.
Not every case is the same, and severe cases can reach the point where they are clearly not beneficial, he emphasizes.
Provided by McMaster University (news : web)
On a daily basis I am asked questions about Addiction. With so much information out there, it can still be very confusing for one to find an answer that fits their specific question. Sometimes these questions come from family members, concerned friends, employers, fellow employees, Physicians’, counsellors, clergy, School Principals, Associations, Police Officers, Lawyers, and just about every walk of life.
The reality is Addiction affects everyone. There isn’t anyone who doesn’t know someone who is addicted. It might be your neighbour, school friend, secretary, boss, son, daughter, husband, father, mother, brother or sister. They may or may not be asking for help.
The confusion lies in what to do.
With so much contradictory information out there, who do you trust.
I don’t have all the answers, but I am a good listener and a good researcher….. I speak to those in recovery, those actively who are actively using, those that are trying to help them with medical or non-medical support, and those that are enabling them and preventing them from reaching for help.
Some believe that they just have to want it bad enough to get the help they need and others believe that their “sick” minds will preventing them from accepting the help, even when it is right in front of them.
So I have been asked to address some of these questions and hopefully provide you with my twist on what I might see as a solution to your dilemma, or offer some feedback that encourages you to make some changes, or lastly to have you maybe look at an alternative way of dealing with the situation that you keep finding yourself in.
I guess I can be Good Cop and Bad Cop….I want you to pretend for a minute that I am in your kitchen and we are having a cup of tea and just chatting about life. As a friend, I will listen to your question and give you my honest answer. You can take it or you can leave it. No harm, No Foul.
I thought I would share a couple of standard questions that are presented to me on a daily basis, just so we can get the ball rolling and you can digest my answers and see if I am the type of friend that you feel comfortable being honest with……. and if so, then forward your question to my column “A CUP of T”
I suspect my son is using drugs. He is 21 years old and lives at home with us. He has been hanging out with some new friends and is very angry all the time with us. He yells and screams that we aren’t giving him space and we are causing him to be angry. He is not working and sleeps all day and goes out all night. I wait up for him as I am worried and cannot sleep until he gets home. When he is home, he stays in his bedroom. What should we do?
Ok he is 21years old and ruling your home with his schedule. He has a right to his own friends, his own schedule. BUT you have right too. I would suggest you sit down with him and tell him what your house rules are. No-one lives anywhere for free. Friends would not put up with this for sure. He needs to work or be in school. If he is not working then he needs to be focused on obtaining a job… any job and in the interim…he needs to volunteer. He needs purpose! He also needs to share in the household responsibilities. Lastly, I would also suggest purchasing a few drug kits. (in case one gets spoiled) and asking him to do a urine test as you suspect he is using drugs. Outline to him that “your” home is drug free. If he refuses to do drug test…. then he must leave. If he tests positive, then you need to figure out how he is going to get some help.
My husband just got charged with a DUI and is in jail, what should I do to help him.
You cannot fix the problem. Only he can. You can be there to support him if he chooses to get some help with his drinking… but that is all. Do not baby him or believe that he has learned his lesson and will never drink again. He needs help with his addiction and must be open to seeking help. Provide him with options for treatment and then see what he does. He needs to want this more than you do.
Understandably when I speak to people of the phone, it is not as black and white as these answers, but I think you get the gist of my message. So, please forward any questions or concerns that you might have to me and I will do my best to provide you with a honest and open answer. I invite you into my home for a Cup of T
written by Tammy Francoeur
The Fifth Estate
It was touted as a miracle pill: a narcotic pain reliever that could change the lives of people suffering from chronic pain, but with little — so its maker claimed, and thousands of doctors believed — risk of addiction.
Since OxyContin was introduced in 1996, Canada has recorded the second-highest number of prescription opioid painkiller addictions — and the world’s second-highest death rate from overdoses.
“It’s helping your pain, but then you get immune to it, so then you go to the family doctor and he says ‘Well, you’re gonna need more,’” a woman who became addicted to OxyContin tells the fifth estate’s Linden MacIntyre. “So he puts you on the 40 milligram (dose) and you’re on that for a month, and then you get used to that dose and he puts you on the 80s.”
But how did a little pill that only appeared in 1996 become so big, so fast? In 1998, Canadian sales were just a few million dollars. Twelve years later they had soared to $243 million. In the U.S., sales were $3.5 billion in 2010. Though there were differences in corporate style and legal structure between Purdue in the U.S and in Canada, a similar marketing approach proved wildly successful. the fifth estate examines why medical schools, GPs and specialists in pain clinics readily embraced the drug at first, and why some have now changed their minds.
OxyContin has recently been dropped from provincial health plans in Ontario, Saskatchewan and Atlantic Canada. The manufacturer has now stopped making it altogether, replacing it with a new formulation known as OxyNeo. But is it too little, too late? Did the drug’s maker low-ball the risks? Did they know their time-release miracle pill was really a time bomb of addiction, waiting to go off?
To view this episode of The Fifth Estate click the url below
By Don Lehn
Friday, March 02, 2012 11:00 AM
Chilliwack, B.C. - BC’s Health Ministry will no longer cover Oxycontin and has placed restrictions on the sister drug Oxyneo. The opiate suppresses legitimate pain, when used properly. Addiction specialist Dr. Caroline Ferris who also works at the Creekside Withdrawal Management Centre in Surrey as well as working for Fraser Health, says be prepared for a panic in the streets from addicts. Some addicts have been getting the drug through prescriptions, but most get it illegally.
“If you were an opiate addict, say in Ontario, the odds are that you are addicted to just Oxycontin. If you are an opiate addict out here, you are either/or addicted to Heroin or Oxycontin.(Heroin is more prevalent on the coast as opposed to other parts of the country.)
Ferris says in the Fraser Valley, this rings true, especially among First Nations people. For all addicts, if they can’t get those pills, they could switch to heroin. Oxycontin sells for $50-$60 per 80 milligram tablet on the street. It is traded just like a regular currency.
The replacement, Oxyneo is harder to break down for use on the street, but packs the same punch. Oxyneo does not break down easily into a powder to be snorted or injected. Oxyneo has become a replacement because the pills are harder to crush and when mixed with water or any other liquid, they turn to jell and
impossible to inject.
The complete document on the drug restriction is as follows:
The College of Physicians and Surgeons of British Columbia is forwarding two important drug updates to you on behalf of the Ministry of Health:
1. National shortage of drugs produced by Sandoz Canada
The Ministry of Health is aware of the national shortage of a number of drugs produced by Sandoz Canada and is actively working to minimize the impact to patients. This supply situation is due to operational issues at the Sandoz manufacturing site in Boucherville, Québec as well as other related logistical issues.
The Ministry is working with Sandoz, Health Canada, other provinces and the health authorities including Health Shared Service BC to manage the situation. Current stock levels of all Sandoz products are being reviewed and monitored across the province on a daily basis. For some unavailable products, clinical alternatives have been identified. However, for products where there are few or no alternatives, judicious allocation of stock will be necessary. Alternate suppliers are also being explored.
The affected drugs are mostly injectable products used in hospitals, as well as a few topical eye products. While the impact of the potential shortage will be greatest on patients in the hospital, the Ministry recognizes that some patients in the community may also be affected. Physicians in the community should note that there is restricted availability of injectable morphine and injectable hydromorphone. The Sandoz situation does not affect the company’s solid oral product line, nor does it affect patches or somatropin (Omnitrope™).
As per usual PharmaCare process when drug shortages occur in the community, appropriate products can be made temporarily eligible for PharmaCare coverage. The Ministry will continue to work with physicians to ensure that the best alternatives are made available for patients who are impacted.
Health care professionals should reassure patients not to panic. There is also no need for physicians or patients to stockpile Sandoz products. The Ministry encourages all health professionals to work with others across the spectrum of acute and community care, to ensure that we take the best care of our patients during this situation.
Future updates will be provided as necessary.
2. Changes to BC PharmaCare’s Coverage for Controlled-release Oxycodone (Oxycontin )
Effective March 8, 2012, PharmaCare is discontinuing coverage for controlled-release oxycodone (Oxycontin ) used to treat moderate to severe pain, and will consider only exceptional case-by-case coverage of the new product, OxyNEO . This follows the manufacturer’s decision to discontinue production of Oxycontin and market the new product, OxyNeo .
For patients with current annual Special Authority approval for OxyContin , PharmaCare will continue to cover Oxycontin and OxyNEO until their Special Authority approval ends. After reassessment, and if still appropriate, physicians may request exceptional coverage by providing supporting rationale in a letter to Special Authority.
Patients with indefinite Special Authority approval will be granted transitional coverage until February 28, 2013 for Oxycontin and OxyNEO to allow time for physicians to reassess the appropriateness of the patient’s pain management.
Palliative care patients will continue to receive coverage for Oxycontin and OxyNEO through PharmaCare Plan P.
PharmaCare encourages physicians to work with their patients to reassess the appropriateness of pain management. For patients continuing on controlled-release oxycodone with OxyNEO , a new prescription will have to meet the requirements for controlled drug products. The College of Physicians and Surgeons of BC’s Duplicate Prescription Program and Prescription Review Program ensure that drugs like OxyContin are securely and appropriately prescribed.
1. Accept what you have.
2. Enjoy what you do.
3. Live for today.
4. Choose happiness.
6. Stay busy.
7. Don’t compare.
8. Be yourself.
9. Stop worrying.
10. Get organized.
11. Think positive.
12. Value happiness.