If I may, I'll note that there are several layers of information. At the large population level, there's obviously epidemiologic data that's obtained from the surveys that have been referred to previously, some of them looking at health behaviours, and some of them looking at reports of drug use.
The RADARS program in the United States that Dr. Bromley referred to is one that captures a great deal of population data, which can describe specific drugs of abuse. We don't have a comparable system in Canada—certainly not realized at that level of complexity.
In terms of the individual physician's capacity to effectively monitor and treat their patients, a prescription monitoring program that captures not just specific drugs but all of the drugs that a patient may receive, from whatever source, allows physicians to actually be fully aware not only of drugs of abuse, but of a variety of relevant drugs that may have other impacts.
It is the case, for example, that certain drugs enhance liver enzyme activity, which means that other drugs will be less effective because they are more quickly metabolized, and you may have to adjust doses. There are other drugs that interfere with each other, so that a painkiller may be more or less effective.
If you're not aware of a patient's full receipt of medications, you're frequently hampered. In my pain practice, for example, I will ask a patient what drugs they take. They will limit themselves to telling me about the pain medications they take that I have prescribed them. I have to actively seek to find out the remainder of their drugs.
British Columbia has a program whereby the physician can run online a complete drug record during patient visits. It's captured at the pharmacy dispensing level, so it doesn't matter who pays for it. Alberta, I believe, has a similar system.
Many of the provinces have systems that report the drugs that are paid for by a provincial benefit program. In Ontario, for example, the Ontario drug benefit formulary can permit its pharmacists to track that medication list. It's hard for a physician to capture that.
Other provinces are bringing into play prescription monitoring systems, but that is one of the areas where a national program linking those...but first of all, allowing the dispersal of best practice.... Some provinces have already solved this problem, so you may not need a unique solution if you don't already have one. The other thing is to make them communicate.