By Jennifer Vardy Little
The drug problem in the Annapolis Valley is no worse than anywhere else in the province, says Health and Promotion Minister David Wilson.
Wilson thinks a few well-publicized drug deaths in this area – including the recent death of 19-year-old Katanna MacDonald June 21 due to an overdose on methadone not prescribed to her – have created a perception that the problem is worse thatn in other parts of the province.
Not so, says Wilson, who assembled a team of experts from across the province for an exclusive editorial board session with The Kings County Advertiser last week, in anticipation of a W5 investigative report that aired Oct. 13 on CTV focusing on the prescription pill epidemic in the Annapolis Valley.
“There’s no question that whenever someone loses their life, it’s tragic,” Wilson said. “Media attention around the death heightens the misinformation that’s out there.”
But there’s no doubt there’s a drug problem in Nova Scotia and across Canada, says Dr. Gus Grant, with the College of Physicians and Surgeons.
“This is not a problem that’s unique to the Annapolis Valley or unique to Nova Scotia – it’s a series of problems that penetrate to a level that very few people appreciate. It’s a worldwide problem of staggering dimensions,” Grant said.
Grant cited numbers from a recent study in the United States, which revealed 38,000 people died from motor vehicle accidents. In the same year, 37,000 people died of overdoses from these medications.
There are no similar figures available in Canada or Nova Scotia, he said, because the numbers aren’t being tracked.
“Sadly, that’s an incredibly hard thing to measure and we’re working on it,” said Grant, adding that there was recently a change in legislation allowing the medical examiner to share information with the prescription monitoring program and police, allowing them to investigate deaths that may involve prescription drugs.
“Sadly, and extraordinarily, it’s a very hard thing to measure. The fact that it’s hard to measure speaks to the fact that we’re dealing with people who are, largely, disenfranchised.”
It’s sometimes difficult for doctors, he said, to determine if their patient requires treatment from opiates.
“You have patients who are saying, ‘I’m in pain, please help,’” he said. “There are many conditions where there are no tests that support the patient’s symptoms. It’s a tough situation… you have to take into account the rights and experience of a patient who is in pain and also consider the presence of the disease of addition and all that goes with it.”
The province, said Wilson, is working hard to reduce abuse – but not at the expense of denying treatment to those who need it.
“Methadone, for example, is a legitimate, proven treatment for opiate dependency,” he said, adding the importance of those treatment programs aren’t often spoken about.
“There are people in every community across the province who are going back to school, who are re-entering the workforce, because they’re able to gain access to methadone and a methadone treatment program.”
There’s no question that whenever someone loses their life, it’s tragic. - Minister of Health David Wilson
Kevin Fraser, Annapolis Valley Health Addiction Services manager, said the methadone program here in the Valley is working well. So well, in fact, that since last October, 94 people received treatment and there is no waiting list, enabling AVH to open up the program to people in other parts of the province.
The program, he added, is unique to the Valley and specifically designed with the needs of rural residents in mind.
“The eyes of the province are watching what’s going on in the Valley,” he said. “There’s no one on the wait list, and that just shows the impact of the program.”
Online portal helps doctors, pharmacists make decisions
It’s not a new program, but updated legislation and new, 24-hour access capabilities are making it easier for pharmacists and doctors to determine whether prescribing and dispensing narcotics is a good idea.
In 1991, a program was launched that aimed to cut down on prescription drug abuse. Back then, doctors filled out any narcotic prescriptions in triplicate, and six weeks later, it would be entered into a system that helped identify abuse.
Susan Wedlake, registrar of the College of Pharmacists, said the process has improved over the past few years. Now, when a patient comes in to fill a prescription, a pharmacist can access the portal 24 hours a day and do a quick review of the individual’s prescription use right across the province.
“This allows the pharmacist to make a better decision on whether or not it’s appropriate to fill that prescription,” Wedlake said.
Before, she said, pharmacists might see a patient come in to fill a prescription at midnight on a Friday, when their doctor couldn’t be reached.
“They’d try to pull the wool over our eyes,” Wedlake said.
The new portal, introduced last April, also has features alerting pharmacies of any robberies or stolen prescription pads and provides steps other pharmacies can take to prevent it from happening to them.
It also gives doctors important information on their patients, said Grant, and not just in helping to identify people who may be abusing the system.
“The information it relays to the clinician is important and provides insight into what may be going on with the patient, any changes on the condition or nature of their pain.”
Fraser said the health authority has taken steps to stop the flow of prescription drugs onto the streets as well.
“We’re wanting to ensure we have internal communications and flags within our system, particularly for those that don’t have a family physician, so that our system is aware there is a plan in place and they know how to reach that plan,” he said.
There are attempts being made at a national level, as well. Two weeks ago, Wilson hosted all of the health ministers from across the country. Unanimously, the ministers agreed to ask the federal health minister to hold off on approving a generic version of Oxycontin for use in Canada. That will give the provinces time, Wilson said, to look at all of the ramifications the generic version might have.