Opinions

Over Prescribing Evident In Nova Scotia

pillshydro

There has been another arrest made in the Annapolis Valley in connection to a methadone overdose. The dealer has been charged with trafficking a controlled substance.

This weekend Annapolis Valley Health and local police collected over 35,000 prescription pills in one afternoon during their RX Drug Take Back Day. The Annapolis Valley has a population of around 120,000 people.

This is not going to solve the problem of diversion or even put a dent in it but it does send a very strong message. If doctors are only prescribing pills in doses that “patients need” how can 35,000 pills be returned by patients who felt they did not need them? This should send a strong message to the medical community , prescription monitoring , and college of physicians and surgeons that they should re-evaluate what they consider best prescribing practices. Over the past 5 years 269 people have died from an opioid overdose in Nova Scotia. That equals approx one person a week! How can the people who have control over prescribing deny this any longer? I emailed the new manager of Nova Scotia Prescription Monitoring with my concerns about some thing the Auditor Generals report pointed out. I asked why only 2% of red flags concerning prescribing over the recommended threshold had been followed up with. Instead of saying the program is going to try harder at following up with over prescribing red flags , he indicated they are going to alter the system so less red flags go off.

“In terms of the areas noted in your e-mail, the NSPMP Board agreed with the Auditor General’s recommendations regarding the current processes related to the Drug Utilization Review.  It is important to note that all cases (avg. 2,000) were reviewed and only 2% were identified as a potential concern.  All of those deemed a concern were followed up.   We actually need to look at the process for flagging concerns so that fewer “acceptable” prescriptions get caught up in the system.  Today, we cast a very wide net when flagging prescriptions for review.  By casting such a wide net, the program necessarily catches a large number of false positives – this explains the large volume of flagged reports that ultimately are determined to be acceptable.  Our intention is to change this process so that fewer acceptable prescriptions are caught up in the net. “ – Kevin Lynch PMP Manager

Maybe the prescription monitoring program needs to take a look at what they deem as an acceptable prescription. If someone is dying every week in our province due to an opioid overdose and dealers can stay in constant supply of pharmaceuticals , how acceptable can these prescriptions be?? The medical consultant for prescription monitoring is also the manager of Nova Scotia Chronic Pain Collaborative Care Network  funded by Purdue Pharma and Pfizer , both opioid medication manufacturers. He also receives an honoraria from Pfizer and Valeant , both opioid manufacturers. Is this not a conflict of interest?

Peter Macdougall was quoted in the Herald saying :

“It would be unethical for the medical establishment to turn away from a class of pain-killers that brings relief to the vast majority of patients because they also bring untold misery to a small minority”

Is one person dying a week and thousands addicted in Nova Scotia a small minority Peter?

I know doctors who strongly feel different !

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