I'm Beth Sproule, and I'm a clinician scientist in the pharmacy department at CAMH, and also with the University of Toronto.
I want to follow up on the remarks, specifically around the monitoring and surveillance piece and recommendations, again, supporting and echoing the recommendations in the CCSA document, “First Do No Harm”.
As Mr. MacPherson said, and I want to repeat, Canada at the moment does not have a comprehensive surveillance system for knowing where we are on the extent of the problem, the numbers and the impact of the problem. We have bits of information from different sources and different parts of the country, but not a systematic view, and certainly not the routine surveillance mechanisms that they have in the U.S., for example.
I think that's quite important, not only for knowing where we are, but also for any of the interventions we're now striving to implement. We need to be able to monitor the impact, and the only way to do that is to know where we're starting from and then look at change.
Again, as mentioned here, we want to prevent the problems of prescription drug abuse, but we also want to keep the drugs available for their therapeutic use. Any intervention could impact either way, and we need the surveillance system to keep track, so that whatever interventions we're doing are in fact reducing the harms but not reducing the availability and benefits of the drugs as well.
One of the key types of surveillance activities is prescription monitoring programs, which have been mentioned. These are thought to be quite important. I think that in Canada we have a few good programs in different provinces. We need to come together to look at the best practice evidence, what features of these programs are the most effective, and how well they do at monitoring the issue.
They also serve as an intervention. It's by identifying patients or prescribers that prescription monitoring programs serve a kind of dual role, of monitoring and also by having interventions in a prevention role.
Knowing what we do now, I think there are some documents about best practices, but also there's a lot of research that's needed to evaluate what these best practices are, and again, evaluate their impact.
Those were the main points I wanted to make.
Thank you.