STEVE RUSSELL/TORONTO STAR

OxyContin is a potent painkiller.

Painkiller deaths targeted

The provincial coroner's office has launched a plan to reduce the high number of Ontario deaths caused by a highly addictive prescription painkiller often trafficked as a street drug.

The move was prompted by a Toronto Star investigation into soaring deaths rates from oxycodone, a drug commonly sold as the painkiller OxyContin and called "hillbilly heroin" on the street, where a $4 pill sells for $45.

"Our office is deeply concerned with the number of deaths due to oxycodone intoxication," said Dr. Bert Lauwers, deputy chief Ontario coroner. "People should not be dying unnecessarily because of a prescription drug."

Provincial data obtained by the Star revealed that an estimated 464 people died from an oxycodone overdose over the past five years, with the number steadily increasing each year. The Star also found the rate of people addicted to the easily obtained drug increasing, and that prescriptions of the brand OxyContin paid for by Ontario's public drug benefit plan had zoomed from $19 million five years ago to $54 million last year. The majority of the prescriptions were for people on social assistance.

Lauwers "commended" the Star for bringing attention to the issue. Soon after the story was published in late January, Ontario's health ministry announced it would lead a national review of the problem.

Now the coroner's office, with its mission to prevent future deaths by studying the past, is developing an action plan. Typically, coroners work through the inquest system and Lauwers said they are looking for an "ideal case" to be the focus of an upcoming inquest.

"There's a great public need" for such an inquest, Lauwers said.

Inquest juries have the power to make recommendations to government and other bodies. Among the groups with a stake in this type of inquest would be pharmaceutical companies, the health ministry, and the provincial College of Physicians and Surgeons, which regulates doctors who prescribe the drug.

Next, Lauwers said the coroner's office is setting up a tracking system to look at common issues in oxycodone-related deaths. Previously, greater attention was focused on heroin and cocaine as the addictive drugs causing the most problem in Ontario. But oxycodone has long surpassed heroin as a killer and is creeping up on cocaine. In a recent five-year period, 49 deaths were blamed on heroin and 641 were blamed on cocaine.

Oxycodone was developed in the early 1900s. It is a narcotic that is supposed to be prescribed to people in great pain, such as those suffering from cancer. In 1995, Purdue Pharma released OxyContin, a form of oxycodone designed to provide a slow release over 12 hours.

It did not take long for people in the U.S. and Canada to figure out that by crushing the pills they could snort or inject the drug for an instant and very powerful high.

After addiction rates and deaths soared in the U.S., state officials took action. In West Virginia, Purdue and three top executives pleaded guilty in criminal court to downplaying the addictive nature of the drug and paid $635 million in fines and were put on five years probation. Purdue agreed to change its marketing strategy to include better warnings to patients.

In Canada, Purdue spokesperson Randy Steffan has told the Star that the company complies with all federal regulations, and no change was made to promotional materials as a result of the American case.