I don't have a background in medicine.
Evidence of meeting #12 for Health in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was drugs.
A recording is available from Parliament.
Evidence of meeting #12 for Health in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was drugs.
A recording is available from Parliament.
9:50 a.m.
Director, Government Affairs and Health Policy, Reckitt Benckiser Pharmaceuticals Canada
I don't have a background in medicine.
9:50 a.m.
Director, Government Affairs and Health Policy, Reckitt Benckiser Pharmaceuticals Canada
No.
9:50 a.m.
Conservative
Terence Young Conservative Oakville, ON
I'm sorry, because it says here that you're director of health policy and treatment.
9:50 a.m.
Director, Government Affairs and Health Policy, Reckitt Benckiser Pharmaceuticals Canada
Yes, that is correct.
9:50 a.m.
Conservative
Terence Young Conservative Oakville, ON
Does your company recommend any non-drug therapies to treat addictions?
9:50 a.m.
Director, Government Affairs and Health Policy, Reckitt Benckiser Pharmaceuticals Canada
Yes. Actually, if you look into our product monograph, we will always say that any form of medication-assisted therapy should always be used in the context of psychosocial support. You can't just do one-offs.
9:50 a.m.
Conservative
Terence Young Conservative Oakville, ON
Thank you.
I want to read you something. I do a lot of research on prescription drug safety, so while I was sitting here with my BlackBerry, the first website I went to was drugs.com, and I looked up Suboxone, and here's what it says: “Misuse of narcotic pain medication can cause addiction, overdose, or death.” This is on the information for the drug that you're proposing. It also says who shouldn't take it, what other drugs affect it, and it issues a warning.
I think you heard the coroner say there are a lot of comorbidities or co-addictions, and I'm sure you're aware of that. It says for Suboxone, “Dangerous side effects or death can occur when alcohol is combined with Suboxone.”
You're recommending to this committee that we recommend that all formularies include Suboxone for all hospitals and any centres—
9:50 a.m.
Director, Government Affairs and Health Policy, Reckitt Benckiser Pharmaceuticals Canada
No, I didn't include Suboxone.
9:50 a.m.
Conservative
9:50 a.m.
Director, Government Affairs and Health Policy, Reckitt Benckiser Pharmaceuticals Canada
No, I said “naloxone”.
9:50 a.m.
Conservative
Terence Young Conservative Oakville, ON
Oh, sorry.
Getting back to your product, basically your company has one product, a drug, which is an opioid, which is the problem we're dealing with, and your product can become addictive.
9:50 a.m.
Director, Government Affairs and Health Policy, Reckitt Benckiser Pharmaceuticals Canada
Yes, right.
9:50 a.m.
Conservative
9:50 a.m.
Director, Government Affairs and Health Policy, Reckitt Benckiser Pharmaceuticals Canada
Well, yes, that comes from the belief that you're giving a drug to somebody to treat addiction, so you're giving a drug to a drug addict. That being said, there are a number of studies that prove the safety of it when used as prescribed.
9:50 a.m.
Conservative
Terence Young Conservative Oakville, ON
Thank you very much.
Dr. Skinner, I want to follow up on what the parliamentary secretary was talking about with regard to manner of death.
I've done a lot of work on prescription drug safety. One of the roadblocks we have is that deaths related to prescription drugs end up being covered up in the media, etc., first of all because they don't publish suicides, and I understand why, because it can create clusters, but also because when a doctor gives a prescription drug to a patient and they die, the manner of death is always natural, so no one sees a need to investigate.
I pleaded with the justice committee—with two other parents who had lost children to prescription drugs—in 2005, with the Province of Ontario that a new category for manner of death be created that would be either prescription drug or iatrogenic error. They totally ignored us, and they changed the act to get the minister's responsibility right out of it altogether.
Don't you think it would be better if there were a category so that families and patients, and the public and the media could be aware when a doctor had given a prescription drug to a patient and the patient died?
9:50 a.m.
Regional Supervising Coroner, Office of the Chief Coroner for Ontario, Ontario Ministry of Community Safety and Correctional Services
No, I don't.
9:50 a.m.
Regional Supervising Coroner, Office of the Chief Coroner for Ontario, Ontario Ministry of Community Safety and Correctional Services
I don't think it would add anything to our ability to investigate, to obtain that information, or to share that information over what we have. What it would do is it would make it very difficult for us to share information with other jurisdictions because of the addition of that category.
9:50 a.m.
Conservative
Terence Young Conservative Oakville, ON
To help cover up deaths. Don't you think that helps absolve doctors of mistakes they've made?
9:50 a.m.
Regional Supervising Coroner, Office of the Chief Coroner for Ontario, Ontario Ministry of Community Safety and Correctional Services
9:50 a.m.
Conservative
Terence Young Conservative Oakville, ON
Here's another question, then. When patients get addicted to opioids, which is one of our biggest health problems in Canada, whose fault is it?
9:50 a.m.
Regional Supervising Coroner, Office of the Chief Coroner for Ontario, Ontario Ministry of Community Safety and Correctional Services
That's a very difficult question to answer. If you're asking me as a physician.... I think what you're getting at is whether the physician has a responsibility if someone dies as a result of a medication prescribed by that physician. Is that your question?
9:50 a.m.
Conservative
Terence Young Conservative Oakville, ON
Yes, or if they get addicted. Let me give you an example.
Dentists in Ontario, and I don't know about the rest of Canada, are giving young people who get their wisdom teeth out opioids. They are giving them oxycodone or OxyContin, the most addictive drug known to man. I have at least two in my riding of Oakville whose parents drive them to Burlington every week, sometimes twice a week, to get the methadone they've become addicted to when they got their wisdom teeth out. Whose fault is that?
9:55 a.m.
Regional Supervising Coroner, Office of the Chief Coroner for Ontario, Ontario Ministry of Community Safety and Correctional Services
The prescriber does bear some responsibility. Dr. Buckley addressed that in your last meeting, that the college of dentistry is addressing that issue within their profession as well.
Similarly among physicians, when I presided at that inquest that was referenced earlier, it's an uncomfortable position to be responsible. As physicians we have to step up and take ownership of our role in that. It's not the only factor and that's why it's necessary to have this multipronged approach to the problem.
You're absolutely right that one of the important features is education of physicians. Yes.