What have we learned in the last five years of being part of CoOPDM? We have learned that prescription drug misuse affects everyone, every community, every demographic. It is not about marginalized populations. Jodie Bruketa could be the daughter of anyone here, so this is an issue that requires urgent attention. It is having an impact on our public health and safety and our health care systems.
It's a very complicated issue, as the other speakers have mentioned. These are medications that have therapeutic purposes, and so we need to have access to those medications for legitimate purposes. Fixing this problem is not a simple, one-sided solution. If that were the case, it would have been done a very long time ago. It's a lot more complicated than that.
The tendency is to focus on opioids, but really, there are many medications that have abuse potential. We need to factor in opioids, sedatives, and tranquilizers, as well as stimulants. Canada happens to be one of the highest per capita users of Ritalin, so I think that focusing only on opioids is missing other issues as well.
Discontinuing access to one medication is not going to solve the problem, because what we have seen in Alberta is that communities or patients individually will rotate to other medications, other illicit substances. Alcohol becomes more common, and that itself has unintended consequences. Any efforts we make need to be deliberate, and they need to be comprehensive. We need to look at a very encompassing strategy to improve things.
As mentioned previously, the CCSA document “First Do No Harm”, really did look at a very comprehensive approach. It looked at five different streams of implementation addressing education, prevention, monitoring and surveillance, treatment, as well as law enforcement issues. Really, to be effective you need to address all of those collectively, not pick out a few of them, because the repercussions and the complexity of issues make that really the only viable way we're going to improve things.
The other issue we've learned about is data. Data collection and getting data from multiple sources is critical. As Dr. Sproule alluded, that allows us to quantify the problem and to look at the response to interventions. It also allows us to develop a surveillance system so that we can look at identifying new issues rather than waiting for them to become part of the media, and to look at how to identify things in a much more proactive way.
We need better access to treatment, such as treatment for chronic pain, addictions, and mental health issues, because, as Dr. Selby has indicated, as prescribing practices change, there are more patients with legitimate and sometimes self-induced problems who need access to treatment. If we don't have access to treatment, we are diverting health care situations to the law enforcement system, so access to treatment is a critical part of the solution.
We cannot address this without the leadership of government. This point really can't be stressed enough. In order to change organizations, we need leadership at both provincial and territorial levels, but really that has to come from the federal government to begin with. It's the way we can incite, encourage, and require organizations to make meaningful change. Collaboration is a part of it—it's a big part of it—but with collaboration you still need to have leadership.
In conclusion, the Coalition on Prescription Drug Misuse has accomplished a lot in the last five years. We're a volunteer organization with limited funding and limited influence, and we've brought it to the level of our Alberta chief medical officer of health. It's on their radar, and we're working with them to look at how a governance structure might look in Alberta. I would recommend that this is something we all should be doing across the country.
We are, and have been, a very active partner and supporter of “First Do No Harm”. The strategy is comprehensive. We've got a road map. We've got all the right people at the table, all the right organizations. We're starting to implement all the different streams, and what we need is support and some financial funding. We're asking that you consider that part of your recommendations.
This committee has an important opportunity to do the right thing and to make some meaningful recommendations that can, in a dramatic way, influence the risk of harm so that families such as the Bruketas and people such as Ada, who will speak about her own experiences, will not have to experience the real harms that come from inappropriate medications.
Thank you for your time and interest.