Canada, America's Apathetic Opioid Enabler

Image Credit: Shutterstock
Image Credit: Shutterstock

Canadian Prime Minister Justin Trudeau will make a formal state visit this week to Washington, D.C. The summit will likely focus on trade and energy policy, but President Obama and the prime minister should instead make time to discuss America’s growing opioid crisis and Canada’s role in it. In short, the U.S. banned abusable oxycodone in 2010, but Canada still allows its sale — and it pours across the shared border.

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Two Americans will lose their lives to a prescription drug overdose as you read this. Another two will die in the next hour, and  two more every hour of every day, according to federal statistics.

Monday, the New Hampshire Congressional delegation, whose state we know, has been ravaged by the opioid crisis,  sent a letter  to the Canadian government asking it to help fight prescription drug abuse in both countries by limiting the availability of non-abuse deterrent opioids, including oxycodone pain relievers:

In our states and in Canada, prescription drug abuse is negatively impacting the quality of life of millions of citizens, costing lives, and presenting significant challenges to our first responders and law enforcement officials. It is concerning to us that, as you know, Canada still permits the manufacture and sale of non-abuse deterrent formulations of oxycodone pain relievers, and these drugs continue to find their way across the border to every region and almost every state in the United States.

It is our strong belief that you now have an excellent opportunity to address this urgent matter by proposing a more robust series of measures than those that were contemplated in the original regulatory package.  To that end we respectfully urge you to consider accelerating the timetable for the removal of non-abuse deterrent formulations of oxycodone pain relievers from the Canadian marketplace.

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The horrifying acceleration of opioid-related deaths is increasingly the consequence of federal health care policy set not by our government, but instead our apathetic neighbor to the north: Canada. That’s the real backdrop to the first bilateral meeting of American President Barack Obama and newly installed Canadian Prime Minister Justin Trudeau.

The U.S. Federal Drug Administration in 2010 required drug makers to adjust existing formulations of all oxycodone products, like OxyContin and its generic form, to incorporate tamper-resistant mechanisms that make abuse difficult through injection or snorting. Almost overnight, all American-made oxycodone products had been reformulated, but Health Canada, FDA’s public health bureaucratic consonant to the north, made no such move.

Six years and two governments later, Canada still allows the production and sale of the old, abusable formula. Worse, Canadian health care regulators continued during this period to approve the sale of new, abusable generics based on the old formula.

A trio of Republican senators—Roy Blunt of Missouri, Jeff Sessions of Alabama, and the since-retired Tom Coburn of Oklahoma, all three representing states with disproportionate rates of opioid addiction — for years had urged Canadian health care officials to expedite the removal of abusable oxycodone from the market.

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The Canadian Minister of Health, who could implement stricter opioid regulations in as little as three months, was for years unmoved by these pleas. Then, in 2014, Canada’s then-Conservative government moved to adjust the market and remove abusable forms of oxycodone. But with the ascension of Trudeau’s Liberal Party, those regulations were unwritten.

In the absence of abuse-deterrent formulations of opioid drugs sold in Canada, Americans will continue to die.

This deliberate abandonment of responsibility has enabled America’s deadly opioid addiction. Abusable Canadian oxycodone medicines have streamed across the two nations’ borders and can today be purchased in 49 of 50 states, epidemiology researchers have found.

Don’t believe it? Make a quick visit to the website of StreetRX.com, a crowd-sourced health surveillance program that tracks the street price of prescription and illicit drugs. According to the service, an addict in New York can purchase a 10-milligram (mg) pill of the old, abusable formulation from Canada for just $5; in Tennessee, an addict can score a 20-mg pill for $8.

The addicts who purchase those drugs could be the next two to die, and their deaths would be the fault of Trudeau’s government. Canada’s outmoded drug policy, among the most generic-permissive in the world, is directly enabling the deaths of Americans.

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Generic drug makers shouldn’t be allowed to continue flooding the market with abusable medications. A reduction in the production costs for Canadian drug makers is not worth the two American deaths every hour it causes.

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