Léger Survey Reports 84 Per Cent of Ontario Physicians Feel Patients May Be Addicted to Prescription Painkillers

Access to New Treatment is Needed to Manage Prescription Painkiller

Dependence Without Risk of Overdose or Misuse

KIRKLAND, QC, Sept. 3 /CNW/ - Prescription painkiller dependence is a serious problem in Ontario, according to the results of a new survey conducted by Léger Marketing polling 211 Ontario General Practitioners. The survey reports that the majority of Ontario physicians (84%) feel that their patients may be addicted to commonly-prescribed painkillers (i.e., opioid-based such as oxycodone, morphine, meperidine and acetaminophen-codeine)(1).

"Prescription opioid dependence is a growing health concern in Ontario," said Donnie Edwards, Port Colborne Community Pharmacist and Certified Drugs of Addiction Expert. "I have seen first-hand how this type of dependency can affect many aspects of a person's life including marriage, friendships, employment, financial standing and judgment, whereby personal safety becomes secondary to the need to obtain opioid-based drugs."

"As a front-line health care provider specializing in drugs of addiction, my hope is for better access to treatments that will benefit Canadians who suffer from opioid dependence," added Edwards. "It's important to have new choices. Arming health care providers with another weapon in the fight against opioid dependence will serve to help patients manage this disease."

Dr. Joel Bordman, Medical Director of the Complex Pain Program at First Step Medical Clinics said, "As a physician working with opioid dependent patients, I am well aware of the current trend of opioid abuse. There is a need for a new, safe and effective substitution treatment that lowers the potential for misuse and overdose, while providing patients who are dependent on opioids the opportunity to manage their symptoms, take control of their lives, and stay on the road to recovery."

Available in Canada since the end of 2007, SUBOXONE(R) (buprenorphine / naloxone) is the first new treatment for opioid dependent patients in over 30 years(2), suppressing the symptoms of opioid withdrawal, reducing the cravings for opioid drugs(3), and designed to deter misuse. However, SUBOXONE is not widely accessible to patients in Ontario at this time.

SUBOXONE combines buprenorphine with naloxone. Buprenorphine, a partial opioid agonist, helps manage the cravings associated with opioid withdrawal(6). The naloxone component of SUBOXONE reduces the potential for misuse by causing unpleasant withdrawal symptoms if the product is misused by intravenous injection by an opioid dependent person(4). SUBOXONE has a 'ceiling' effect, whereby its physiological effects level off at a certain point, even at higher doses(5). Treatment may include take-home doses after a period of two months, based upon an assessment of the patient's clinical stability and their ability to safely store the product at home(9).

People use opioid-based medications to manage pain. The vast majority use their opioid medications properly and benefit from reduced pain and improved quality of life. However, some people have a predisposition for addiction and may become opioid-dependent, although it is not because of a lack of morals or willpower(6). Treating opioid dependence offers many medical and personal benefits to patients, their families and society as a whole(7). Unfortunately, there are a limited number of treatments and a limited number of physicians who can prescribe them.

In Ontario, approximately 30,000 people regularly use illegal opioids, most of which are diverted from the medical system. Just over half of these individuals receive treatment(8). Over the last decade, there has been an increase in illicit drug users abusing prescription opioid drugs(9).

Symptoms of opioid dependence observed by Ontario physicians include using more than intended (96%), needing a higher dose to obtain the same effect (91%), being unsuccessful at cutting back (86%), experiencing withdrawal when not taking any medication (82%), and compulsive use despite harm (59%). Requests for additional medications are also common, with 74 per cent of physicians often or occasionally receiving requests for additional opioid prescriptions because their patients have lost their prescriptions or need early refills(1).

Ninety-four per cent of Ontario physicians polled consider drug substitution therapy to be beneficial and 82 per cent feel that it helps break the dependency cycle, allowing patients to regain control of their lives(1). Although methadone is the most commonly prescribed drug substitution therapy for those who are dependent on opioids(1), Ontario physicians are somewhat concerned with the potential for misuse (63%), overdose (62%), and the possibility of combining it with other illicit opioids (60%)(1). 

About SUBOXONE 

Approved by Health Canada in May, 2007(9), SUBOXONE is indicated for substitution treatment of opioid drug dependence in adults. The intention of the naloxone component is to deter intravenous misuse. Patients prescribed SUBOXONE should be carefully monitored within a framework of medical, social and psychological support as part of a comprehensive opioid dependence treatment program(9). The approval of this drug is based on results of a four-week safety/efficacy study in 326 subjects with a maximum daily dose of 16 mg and a 48-week open-label safety study involving 461 patients(10). SUBOXONE is taken once a day as a sublingual tablet placed under the tongue to dissolve(6).

To help ensure appropriate use of SUBOXONE, Schering-Plough Canada is also offering an online education program for health care professionals, accredited by The College of Family Physicians of Canada. The program provides professionals with information needed for product use, supporting the dialogue between patient and physician about the risk and benefits of therapy. It also encourages an approach to care involving the careful monitoring of patients within a framework of medical, social and psychological support as part of a comprehensive opioid dependence treatment program.

Schering-Plough Canada is dedicated to improving patient access to treatment for this disease. SUBOXONE should only be prescribed by physicians who have experience in the substitution treatment in opioid drug dependence, and have completed an accredited SUBOXONE Education Program. Physicians can obtain more information about the SUBOXONE Education Program by calling 1-800-463-5442 or visiting www.SUBOXONECME.ca(9). 

About Schering-Plough 

Schering-Plough is an innovation-driven, science-centered global health care company. Through its own biopharmaceutical research and collaborations with partners, Schering-Plough creates therapies that help save and improve lives around the world. The company applies its research-and-development platform to human prescription and consumer products as well as to animal health products. Schering-Plough's vision is to "Earn Trust, Every Day" with the doctors, patients, customers and other stakeholders served by its colleagues around the world. The company is based in Kenilworth, N.J., and its Web site is www.schering-plough.com

SUBOXONE(R) is a registered trademark of Reckitt-Benckiser Healthcare (UK) Limited, used under license by Schering-Plough Canada Inc. 

(C) 2008, Schering-Plough Canada Inc. All rights reserved.  

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References:

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(1)  Leger Marketing. Opioid Dependence in Ontario.

     http://www.legermarketing.com/documents/spclm/080812ENG.pdf

(2)  Best Practices: Methadone Maintenance Treatment. Health Canada Web

     site. Available at:

 http://www.hc-sc.gc.ca/hl-vs/pubs/adp-apd/methadone-bp-mp/index-eng.php

(3)  Buprenorphine Sublingual and Buprenorphine and Naloxone Sublingual.

     Medline Plus Web site. Available at:

     www.nlm.nih.gov/medlineplus/druginfo/medmaster/a605002.html.

     Accessed Oct. 3, 2007.

(4)  Subutex and Suboxone Approved to Treat Opiate Dependence. U.S. Food

     and Drug Administration Web site. Available at:

     http://www.fda.gov/bbs/topics/ANSWERS/2002/ANS01165.html. Accessed

     July 27, 2007.

(5)  SUBOXONE(R) (buprenorphine / naloxone) Product Monograph, Schering-

     Plough Canada Inc.; May 2007

(6)  Opioid Addiction. National Alliance of Advocates for Buprenorphine

     Treatment. Web site. Available at:

     http://www.naabt.org/education/opioid_addiction.cfm. Accessed

     July 24, 2007

(7)  Research report series - prescription drugs: abuse and addiction.

     National Institute on Drug Abuse Web site. Available at:

 http://www.nida.nih.gov/ResearchReports/Prescription/prescription2.html.

     Accessed August 22, 2007.

(8)  Report of the Methadone Maintenance Treatment Practices Task Force.

     W.Anton Hart ,Chair, March 2007

(9)  Haydon E, Rehm J, Fischer B, et al. Prescription drug abuse in

     Canada and the diversion of prescription drugs into the illicit drug

     market (Commentary). Can J Public Health 2005;96(6):459-61

(10) Fudala PJ, Bridge TP, Herbert S, et al. Office-based treatment of

     opiate addiction with a sublingual-tablet formulation of

     buprenorphine and naloxone. N Engl J Med 2003;349:949-58.

>>      -30-  /

For further information: Media Contacts: Mona Aubin, Schering-Plough Canada, (514) 428-8833, mona.aubin@spcorp.com; Collin Matanowitsch, Manning Selvage & Lee (MS&L), (416) 847-1330, collin.matanowitsch@mslpr.ca/
 

Posted: September 2008


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