Across Canada, the tragic spike in opioid-related deaths has brought to national attention the large and complex issue of drug use and misuse. As fentanyl-related overdoses are gripping the country, there is a connected, but separate crisis of doctor-prescribed opioids being increasingly used on a regular, long-term basis.
Why? Universal drug plans mean national bodies negotiate fairer prices for prescription drugs. The results are dramatic. So, while some critics claim that universal prescription drug insurance is a nice idea, but not affordable - it's very clear that universal prescription drug insurance is actually the key to affordability.
I'm not a marijuana consumer -- never have been, never will be. But, I understand business planning and marketing. Marijuana is a retail product for recreational consumers. For most users, it's not a staple item (after all, it's "recreational" remember) so, they don't always plan ahead. Impulse sales, product expertise, advice from local sales staff, and immediate fulfillment are paramount. Mail-order may be a complementary channel for some users, but it won't be the only channel. The idea it can be, is simply a non-starter.
If you asked Canadians why life expectancy in our country continues to rise -- now 79 years for men and 83 for women -- many might attribute the increase to advances in medicine, such as new pharmaceutical research and surgical interventions. Scientists working in labs, in other words. It's not so simple.
Despite criminal prohibition and the prospect of becoming ill or even dying, people still do drugs. So we are faced with a wrenching dilemma: Do we, as a society, take over and regulate the supply and quality of drugs or do we leave these issues to the forces of an unbridled market operating in a dark underworld?
The War on Drugs has been a failure, and soon enough using drugs will shift from a criminal to a public health issue. But what if we paid people not to engage in harmful consumption? If we rewarded them for stopping damaging use? Couldn't the savings in all manner of costs greatly outweigh the comparatively small expense of any incentive?
I had a good friend of mine become a drug addict. Crack specifically. I never imagined he'd be using it in a million years, but life has a funny way of showing you that anything is possible. He was a natural born hustler. He sold dope at school, at parties and pretty much wherever he could make a buck.
Think of pain as being your "harm alarm," a signal that is designed to get your attention, to motivate you to escape whatever is causing it. After all, pain -- potential harm -- could mean injury or even death. In this way, pain serves a useful purpose because it is functions to keep you safe and alive. But what about chronic pain?
Moby describes this time in his life as "celebratory in the face of squalor" and on many levels that sentiment chimes through each chapter. Providing a private glimpse into his sexual escapades, celebrity encounters, struggles with sobriety and downright shenanigans, the book candidly and often comically details the party before the storm.
Canadians might be surprised to learn that many health and social services widely available in the community are not available in most of Canada's correctional facilities -- this needs to change. We are missing a critical window of opportunity to reframe the period of incarceration as a time to help people improve their health and well-being before returning to our communities.
If you experience withdrawal symptoms, this does not meant that you cannot get off opioids. Withdrawal symptoms mean that your opioid level was dropped too quickly and your body was surprised by the lack of medication. The key is to work with your body to successfully taper your opioids -- by making small changes slowly over time.
Critics have begun pointing the finger at the medical system and its prescribers -- well-meaning doctors and specialists who've been giving too many patients excessively powerful opioid medications to deal with modest pain. But we can dig deeper and look at the relationship between medical education and pharmaceutical company influence as a significant contributing factor.
A 65-year-old man notices he's feeling more tired lately. He's gaining weight and losing muscle. He can't get as many erections, and generally feels foggy and unwell. His family doctor takes some blood tests and rules out thyroid problems, high cholesterol and blood sugar issues. The only finding is low testosterone -- but that's a normal part of aging, right?
If Canada is to implement national pharmacare, surely we want to know more about the drugs we'll be paying for. To this end, we must tackle a pre-existing challenge: we must open up the evidence our drug regulator houses concerning drug safety and effectiveness. For decades Health Canada has kept that information confidential at the behest of drug manufacturers. This practice limits the ongoing evaluation of a drug's safety and effectiveness and, in turn, provincial and territorial governments' decision-making about which drugs to pay for, not to mention physicians and patients who make decisions about which drugs to prescribe and take.