The National Advisory Committee on
Prescription Drug Misuse and the Canadian Center on Substance Abuse published a
document titled First Do No Harm:
Responding to Canada’s Prescription Drug Crisis. Part D, Prescription drugs and associated harms in
Canada, of the document, provides an overview of the crisis with a focus on
the population groups vulnerable to and the specific harms associated with
prescription drug utilization and abuse, as well as the associated costs. Opioids,
sedatives, tranquilizers and stimulants are prescribed as therapeutics for a
number of illnesses and pain management. However, the drugs’ psychoactive and
dependence causing properties, together with ease of access, marketing and other
factors, are responsible for their high propensity of misuse and abuse (National
Advisory Committee on Prescription Drug Misuse, 2013). Todd et al identified that
the most common reason for seeking health care was pain, and opioids are often
employed in pain management. However, primary care practitioners that write a
large proportion of these prescriptions have improper and inadequate training
in pain management and addiction (Dubin et al., 2011; Watt-Watson et al., 2009).

 

Research has identified certain demographics in
Canada that are particularly at risk for harm from the use and misuse of
prescription drugs. These demographics include newborns, youth, seniors, women
and First Nations communities. Drug dependency in neonates, referred to as Neonatal
Abstinence Syndrome (NAS), occurs due to in
utero exposure to psychoactive drugs. Increasing rates of NAS in Ontario
are higher than the national average, and are likely underreported (CIHI,
2012). While rates of prescription drug use in youth are lower compared to
adults (Health Canada, 2012a), the harm caused is more extensive as it affects brain
development, and is linked with increased risk of drug dependence and use of
multiple psychoactive drugs later in life (CCSA, 2007).  Higher prevalence of chronic pain and
insomnia in seniors makes them more likely to take psychoactive medications (Simoni-Wastila
& Yang, 2006). Increased harms from these medications in this population
include higher risk of falls due to confusion and lack of coordination as well
as multiple drug interaction with other prescription medication (CIHI, 2011). Women
also experience higher rates of use and misuse from psychoactive drugs relative
to the general population (Health Canada, 2012b), which may be due to longer
life expectancy, more frequent use of the health care system and marketing
strategies aimed at women in addition to non-medical reasons (British
Columbia Ministry of Health, 2008). Data from the First Nations and Inuit
Health Branch (FNIHB), Non-Insured Health Benefits (NIHB) program depicts exceedingly
high levels of prescription drug use, especially opiates, in First Nations
peoples. Accordingly, rates of harm such as addiction, suicide, crime and
illegal activity, and societal problems are also disproportionately high. Changes
to the NIHB system like monitoring prescriptions, establishing drug limits and real-time
warnings at pharmacies have enabled change in a positive direction. Overall,
the drug issue in Canada has reached crisis proportions and accompanying it are
due to increased rates of death, suicide, visits to emergency rooms, drug
withdrawal and overdose, and demand for drug treatment programs (National
Advisory Committee on Prescription Drug Misuse, 2013). 

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