The National Advisory Committee onPrescription Drug Misuse and the Canadian Center on Substance Abuse published adocument titled First Do No Harm:Responding to Canada’s Prescription Drug Crisis. Part D, Prescription drugs and associated harms inCanada, of the document, provides an overview of the crisis with a focus onthe population groups vulnerable to and the specific harms associated withprescription drug utilization and abuse, as well as the associated costs. Opioids,sedatives, tranquilizers and stimulants are prescribed as therapeutics for anumber of illnesses and pain management. However, the drugs’ psychoactive anddependence causing properties, together with ease of access, marketing and otherfactors, are responsible for their high propensity of misuse and abuse (NationalAdvisory Committee on Prescription Drug Misuse, 2013). Todd et al identified thatthe most common reason for seeking health care was pain, and opioids are oftenemployed in pain management. However, primary care practitioners that write alarge proportion of these prescriptions have improper and inadequate trainingin pain management and addiction (Dubin et al.
, 2011; Watt-Watson et al., 2009). Research has identified certain demographics inCanada that are particularly at risk for harm from the use and misuse ofprescription drugs. These demographics include newborns, youth, seniors, womenand First Nations communities. Drug dependency in neonates, referred to as NeonatalAbstinence Syndrome (NAS), occurs due to inutero exposure to psychoactive drugs.
Increasing rates of NAS in Ontarioare higher than the national average, and are likely underreported (CIHI,2012). While rates of prescription drug use in youth are lower compared toadults (Health Canada, 2012a), the harm caused is more extensive as it affects braindevelopment, and is linked with increased risk of drug dependence and use ofmultiple psychoactive drugs later in life (CCSA, 2007). Higher prevalence of chronic pain andinsomnia in seniors makes them more likely to take psychoactive medications (Simoni-Wastila& Yang, 2006). Increased harms from these medications in this populationinclude higher risk of falls due to confusion and lack of coordination as wellas multiple drug interaction with other prescription medication (CIHI, 2011). Womenalso experience higher rates of use and misuse from psychoactive drugs relativeto the general population (Health Canada, 2012b), which may be due to longerlife expectancy, more frequent use of the health care system and marketingstrategies aimed at women in addition to non-medical reasons (BritishColumbia Ministry of Health, 2008).
Data from the First Nations and InuitHealth Branch (FNIHB), Non-Insured Health Benefits (NIHB) program depicts exceedinglyhigh levels of prescription drug use, especially opiates, in First Nationspeoples. Accordingly, rates of harm such as addiction, suicide, crime andillegal activity, and societal problems are also disproportionately high. Changesto the NIHB system like monitoring prescriptions, establishing drug limits and real-timewarnings at pharmacies have enabled change in a positive direction. Overall,the drug issue in Canada has reached crisis proportions and accompanying it aredue to increased rates of death, suicide, visits to emergency rooms, drugwithdrawal and overdose, and demand for drug treatment programs (NationalAdvisory Committee on Prescription Drug Misuse, 2013).