Prescription drugs off the radar

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Derek Sylvestre died of an overdose in 2008. (HANDOUT)

It was friends who advised Dolores Sylvestre to read last Saturday's column but, as she read, the St. James mother kept stopping. Then starting. And stopping again.

"I was crying," she said over the phone this week.

The column centred on Derek Twomey, the popular 21-year-old gifted athlete and university student from St. Vital whose mother found him dead in his bed last January, the victim of an accidental prescription drug overdose.

No wonder Dolores couldn't stop crying.

The similarities were eerie.

Both boys were named Derek.

Both died of an accidental overdose of the same prescription drug, hydromorphone, a painkiller popularly prescribed to palliative-care patients. Both allegedly got the drug from a friend.

Both were found dead in their bed by a parent.

Of course, there were at least two obvious differences. Derek Sylvestre was six years younger and died three years earlier than Derek Twomey.

The younger Derek was only 15 when he died on Feb. 13, 2008.

"Our world, as well as Derek's, ended Feb. 13," his mom said.

Part of what troubles her is where the hydromorphone came from.

Medication that was left over but never returned to the pharmacy for proper disposal, after a woman died from cancer.

"There is no law for accountability of narcotic drugs once they are dispensed to the public if they are not in a hospital or care home," she said.

That's far from the only critical failing in the system that prescribes, dispenses and is supposed to keep track of the process.

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Years before prescription medicine became a deadly street drug, Manitoba instituted a computerized reporting and tracking system called the Drug Information Network (DIN).

It was supposed to watch for any prescribing irregularities.

And for years that's what was done.

The province funded two positions within the College of Physicians and Surgeons of Manitoba that monitored doctors' prescribing patterns, in part to watch for so-called double doctoring -- the practice of addicts or even pushers going from doctor to doctor fraudulently filling the same prescription. And, of course, the Drug Information Network also watched for doctors who, based on a large volume of painkiller medication, might be willingly filling those prescriptions.

But then, "about five or six years ago," by college registrar Dr. Bill Pope's estimate, something odd happened.

The monitoring stopped.

The Drug Information Network was still collecting and storing drug data from doctors.

But no one was watching.

Let me be even more loud and clear; no one is watching -- and nobody has been watching.

For years.

Pope says that's because health privacy legislation was enacted in the late 1990s, and by about 2004 the college discovered that, under the new law, it wasn't allowed to "go on fishing expeditions." In other words, it wasn't allowed to systematically scan the system looking for illegal activity.

Only when a complaint the college judged to have merit came to its attention could it turn to DIN as part of its investigation.

Last December, Health Minister Theresa Oswald finally acted to correct the problem.

And two months ago, the province passed the legislation that will allow for monitoring of the Drug Information Network to resume. But not before later this year.

Then maybe someone will be watching again.

But that doesn't make up for why they weren't watching for the past five years.

When prescription drug overdoses were killing our kids in ever-growing numbers.

-- -- --

The prescription drug problem in Manitoba won't go away when monitoring of the Drug Information Network finally resumes.

It may never go away.

Yet, what's still missing after all these deaths and all these years is a comprehensive, all-out education program for both doctors and patients.

Especially young patients.

"It has been 3 1/2 years and I have only started to see one TV commercial and radio commercial about the dangers of prescription drugs and youth," Dolores told me this week.

But it's not just the government or the professional bodies that have let us down.

Dolores said nine months after Derek died, she wanted to speak to students at his high school about the dangers of prescription drugs. "But the principal felt it would be too disruptive."

gordon.sinclair@freepress.mb.ca

Republished from the Winnipeg Free Press print edition August 20, 2011 B1