Cubic News
Fighting The Battle: Narcotic Abuse Ontario
December 2011
On November 1, 2011, Ontario’s “Narcotics Safety and Awareness Act” came into force. This new legislation is intended to support the development of a narcotics monitoring database – the first component of Ontario’s new “Narcotics Strategy”, and one of five key elements aimed at “making the prescribing and dispensing of narcotics and other controlled substance medications safer and more secure”[1]. With the introduction of this legislation, Ontario joins the following provinces with prescription monitoring in place: British Columbia, Alberta, Saskatchewan, Manitoba, Nova Scotia and PEI.
Collectively referred to throughout the Act as Monitored Drugs, the new regulations apply to narcotic medications (e.g. OxyContin®), controlled substances (e.g. Adderall®, Concerta®), benzodiazepines (e.g. Ativan®, Xanax®), barbiturates (e.g. Fiornal®) and non-opioid pain relievers (e.g. Tramacet®, Zytram®). It is noteworthy to see that non-prescription requiring products containing narcotic ingredients (such as Tylenol® #1) are also present on the Monitored Drugs list.
The new legislation requires anyone wishing to obtain a prescription for a Monitored Drug in Ontario to provide a piece of approved identification (e.g. driver’s licence) to a prescriber, who records the type of identification used and the identification number of the patient directly onto the prescription. At the discretion of the dispenser, a piece of identification must be provided while filling the prescription for verification purposes. In all cases, the dispenser must document and record the identification information written on the prescription (along with the standard documentation required on all prescriptions), and disclose this information to the Ontario Ministry of Health and Long-Term Care (MOHLTC) for inclusion in the narcotics monitoring database. It should be noted that the system to facilitate electronic submission of patient records to the Ontario MOHLTC is not expected to be operational until Spring 2012.
The resulting collected data will be reviewed and analyzed by the MOHLTC for a variety of purposes, including, but not limited to: “educational and public health purposes, reporting possible professional misconduct to regulatory authorities and reporting possible criminal conduct to law enforcement agencies” [2]. Although this program appears to be a worthwhile initiative by the MOHLTC, it remains to be seen what the Ontario government will actually do with this data they collect. While definitely a step in the right direction, such a monitoring system is not a complete solution to the problem.
In our June 2011 article titled Drug Plan or Dealer Supply Chains? [3], we touched upon the issue of excessive plan spending on large quantities of narcotics being a growing social issue. The enactment of this strategy, and the subsequent monitoring of all narcotic claims and claimants in Ontario, lends support to this. That said, we once again recommend that plan sponsors work with their benefits providers to implement their own Narcotic Strategy, in the form of additional plan provisions and/or therapeutic limits programs to help ensure the safe and appropriate utilization of prescription narcotic drugs within their own plan experiences. Taking these steps will address both the social concerns these medications can represent, as well as the fiscal issue associated with overuse and abuse of these drugs.
[1] http://www.health.gov.on.ca/en/pro/programs/drugs/ons/docs/faq.pdf
[2] http://www.health.gov.on.ca/english/providers/program/drugs/resources/narcotics_manual.pdf
[3] http://www.cubichealth.ca/cubic-health-articles/drug-plans-or-dealer-supply-chains/
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