THUNDER BAY -- Thunder Bay’s chief medical officer of health says the high rate of opioid use in the northwest results from a series of complicated reasons.
That observation from Janet Demille follows a recent report pointing to the repercussions of opioid use across Northwestern Ontario.
The Ontario Drug Policy Research Network found that the region has the highest or among the highest rates of opioid users, opioid-related deaths, emergency room visits, hospital admissions, and opioid maintenance therapy patients (people using drugs such as methadone) in the province.
The ODPRN is comprised of a province-wide group of researchers.
Demille said its report confirms a lot of what Ontario health officials already knew.
“A lot of it is about prescribing practices of health-care providers," she said, explaining the causes.
"A lot of it is the need in the community. Opioids are often prescribed to manage chronic pain. It gets back to issues around addictions and mental health as well, and even what we would call the determinants of health and why people feel the need to have medications like opioids.”
Demille said one contributor in need of being addressed is the over-prescribing of opioids.
“Primary care supporters need to be supported, and that there’s good guidance around the management of chronic pain," she said, adding that "oher options outside opioids need to be explored.”
She added alternatives such as physiotherapy have to be made available for people in chronic pain.
Ontario’s chief medical officer of health agrees that the over-prescribing opioids needs to be dealt with as part of an overall strategy. The government recently appointed David Williams as the province’s first opioid overdose co-ordinator.
“We have two to four times the rate of the rest of the country," he said. "We have gone into a behavior of being very at-ease (with) prescribing opioids."
Contributing to the problem, Williams added, is that “our public, of course, have gotten exposed to that and are demanding of that, to some extent, as well.”
He noted a lot of people with addictions that one might have thought were “out on the street” are "actually now in people’s families and friends and relatives, even their elderly parents or grandparents and in long-term-care facilities.”
Dr. Williams said there is “a big job to do” in terms of making the public and health-care providers aware of the need to reduce if not eliminate the use of opioids in care plans. “We have a long road ahead to turn this ship, if you may.”
He told tbnewswatch.com that, in the near future, a “narcotics atlas” of Ontario will be released in conjunction with the effort to monitor opioid use in particular.
Williams said it will show the extent to which opioids and high doses of opioids are being prescribed across the province. “How they have been used by our health-care providers, the prescribing patterns, geographical layout, and individuals who prescribe a lot, who prescribes a little and who prescribes really high amounts.”
Williams pointed out that some of the high-amount people are palliative-care doctors dealing with patients “in a very severe state.”
In their recent report, the ODPRN researchers described their findings as an opportunity for health officials and policy-makers to identify high-risk areas in the province where services such as addiction clinics, safe injection sites and widespread access to naloxone might have the most impact. Naloxone is a medication that can reverse the effects of opioids.
Williams said the over-use of opioids is a multi-faceted issue with many different components that need to be addressed.
