The two most important things are, first of all, to ensure that the product monographs are objective and are not influenced by pharmaceutical marketing. The product monograph is listened to by physicians. It's in the CPS. Physicians are expected to adhere to it, and it is the basis for advertising and future claims. The product monograph for OxyContin was inaccurate, and the product monograph for Hydromorph Contin, for example, is similarly inaccurate in many ways. That's also a Purdue Pharma product.
So that is number one. The product monograph should not be approved by Health Canada without an independent, objective review.
Second, it is up to educators, medical schools, residency programs, and accrediting bodies such as the College of Family Physicians of Canada, to ensure there is no pharmaceutical influence on the content of the messages. It is unacceptable that Dr. Persaud was confronted with an educational program sponsored by Purdue Pharma and presented by a medical regulator. That is truly a conflict of interest.
Finally, medical authorities, the medical regulators, the colleges of physicians and surgeons, should make explicit prescribing standards. They should say what they expect of physicians in terms of the indication for opiates, who should get them, what are the doses, what is the screening, and what other precautions need to be taken. That needs to be taken outside of the pharmaceutical industry. It needs to be taken out of the hands of pain specialists, who sometimes also have conflicts of interest, and to be put in the hands of medical authorities.