Opiate deaths steadily rising

Accidental overdoses of oxycodone and fentanyl have killed at least 25 Manitobans in the last two years, raising fears more people will die awaiting treatment as waiting lists continue to soar.

New data from the Chief Medical Examiner's Office reveal the number of accidental prescription opiate overdoses is on the rise.

In 2008, 10 people died following accidental overdoses of oxycodone and fentanyl. Preliminary data from 2009 indicate that number rose to at least 15 last year, and some toxicology reports haven't been finalized yet.

Oxycodone is a narcotic pain reliever included in prescription drugs such as OxyContin and Percocet.

Laurie Magee, program director of the Addictions Foundation of Manitoba's methadone-intervention program, said at least half of the people who died from accidental OxyContin overdoses last year were on the program's waiting list.

The continuing surge in prescription painkiller abuse has driven up the waiting list for methadone treatment, Magee said, and put an increased strain on addiction staff, who feel overwhelmed by growing pressure to treat and stabilize patients.

There are close to 700 Manitobans on methadone, but people on the waiting list can't get in for treatment until someone drops out or has stabilized enough to get the drug from a community pharmacy.

The number of people waiting for treatment jumped from 150 to 180 people in the last three months, raising concerns it could take longer than six to 12 months for someone to get help.

"It sounds terrible to say, but we have (the waiting list) colour-coded. We used orange for people we got on the program, green for people who we couldn't find or got options elsewhere. And then we've got writing in there that says deceased, deceased, deceased," Magee said, leafing through the names on the program's waiting list.

"On my first three pages, each page, a person who died."

Last month, the Manitoba government restricted the number of OxyContin prescriptions physicians doledout, in an effort to reduce the supply of opiates sold on city streets, and in turn, the demand for methadone treatment services.

However, front-line workers are still facing a steady increase in the number of Manitobans seeking help for their addictions -- a trend they don't expect to plateau any time soon.

Dr. Lindy Lee, director of Health Sciences Centre's addiction unit, said she knows of 15 people who died from opiate overdoses last year, including patients who were on a waiting list or a relative or friend of a patient she treated.

"I think it will be a slow medical response that will take some years to gain steam," she said of recent changes the government has announced. "My numbers are still steadily going up."

About 80 medical professionals have expressed interest in a training seminar next month to learn how to prescribe and treat patients on methadone. While the idea is to transfer stable methadone patients to community physicians to take the strain off the AFM's program, Magee said it could take six months before doctors are able to start taking some of the client load.

In the meantime, she said front-line staff are trying to keep up with the demand, and deal with the guilt they feel when they have to write "deceased" next to another name on the list.

"They were looking for help and they were looking to us for that help and we were unable to do that," Magee said.

jen.skerritt@freepress.mb.ca

What is OxyContin?

It's a powerful opiate that's also a commonly prescribed painkiller. In the last two years, addiction workers have seen an alarming rise in the number of Manitobans addicted to painkillers like OxyContin.

What is being done to curb abuse?

Starting Friday, prescriptions will be restricted to cancer patients or those with chronic conditions who can't tolerate or benefit from other medications. More physicians will be trained to prescribe methadone to addicts to help ease the strain on current treatment programs. Manitoba is also launching a brochure campaign to educate physicians, pharmacists and patients about the drug.

Can opiate addiction be treated?

Yes, with abstinence or methadone. Methadone is a synthetic opiate that suppresses symptoms of withdrawal, but is tightly controlled. Increased demand for methadone treatment in Manitoba has resulted in long waits for treatment. Some patients drop out of touch while on the waiting list, or resort to crime to feed their addiction. Others are prescribed doses of opiates to tide them over until they can get into the methadone program.

Overdoses by the numbers:

Between 1999 and 2004, the medical examiner recorded about five overdose deaths a year from prescription opiates.

In the last two years, a total of 39 Manitobans died following overdoses of oxycodone and fentanyl, including 25 deaths that were accidental.

In 2008, six people died after accidentally overdosing on oxycodone, and four people died from accidental fentanyl overdoses.

Seven other overdoses were deemed suicides and two other deaths were undetermined.

According to preliminary data from 2009, eight people died after accidentally overdosing on oxycodone and seven people died from accidental fentanyl overdoses. Three other deaths were deemed suicides, and two others were undetermined.

-- Source: Office of the Chief Medical Examiner

Republished from the Winnipeg Free Press print edition May 25, 2010 A6