Ontario Attempts To Combat Oxycontin Addiction

Ontario’s recent decision to eliminate oxycontin and delist its replacement, oxyneo, from the Ontario Drug Benefit program sends a powerful message across the province; that something needs to be done about this epidemic addiction to prescription painkillers.

Oxyneo is a tablet that is purposely difficult to crush and forms into a thick gel when added to liquid to prevent oxycodone from being extracted for use by injection.

Basically, oxycontin will no longer be manufactured in Canada and it will be replaced with a new formulation called oxyneo by the end of February 2012. Additionally, the Ontario Drug Benefit program will not list oxyneo in their formulary; therefore no coverage will exist for those using this program to fund their habit.

Dr. Irfan Dhalla of Toronto’s St. Michael’s Hospital discovered a spike in opioid-related deaths, which coincided with the addition of long-acting oxycodone to Ontario’s drug plan in 2000.

The Ontario Drug Benefit Program (ODB) offered through the Ministry of Health and Long Term Care (MOHLTC) covers most of the cost of prescription drug products listed in the ODB Formulary. It is available to people 65 years of age and older, residents of long-term care homes and Homes for Special Care, people receiving professional services under the Home Care program, Trillium Drug Program registrants and people in receipt of Ontario Works or Ontario Disability Support Program assistance.

That being said, the drug will still be available to certain individuals through the Exceptional Access Program (EAP). This program facilitates patient access to drugs not funded on the ODB Formulary, or where there is no listed alternative available. To apply for funding through the EAP, a physician must submit a request, which documents all complete and relevant medical information that provides a clinical rationale for requesting coverage including the reason(s) that other similar listed drugs are not suitable. All requests are reviewed according to the guidelines put forth by the ministry’s expert advisory committee, the Committee to Evaluate Drugs (CED), which thoroughly assesses each patient’s specific case and clinical circumstances.

In short, oxycontin will no longer be available commercially in Canada and its replacement, oxyneo, will be under more strict regulations in Ontario so that it is less available to just anyone under the ODB, thereby making it less easily abused.

However, with such great strides comes a myriad of problems when all these individuals begin to experience withdrawal. As major changes are being seen at the provincial level only, neighbouring provinces may have less or no restrictions on oxyneo, which may encourage smuggling. For instance, “Manitoba and British Columbia are among a handful of provinces that have yet to decide whether to fund OxyNeo once OxyContin is discontinued” yet Prince Edward Island and New Brunswick, like Ontario, have chosen not to pay for the new drug. Nevertheless, to avoid such great lengths, addicts may simply turn to other prescription drugs.
There is a high risk of experiencing severe withdrawal symptoms if a patient discontinues oxycodone abruptly. Therefore therapy should be discontinued gradually rather than abruptly. People who use oxycodone in a hazardous or harmful fashion are at even higher risk of severe withdrawal symptoms as they tend to use higher than prescribed doses. The symptoms of oxycodone withdrawal are the same as for other opiate based painkillers and may include "anxiety, panic attack, nausea, insomnia, muscle pain, muscle weakness, fevers, and other flu like symptoms.”
Clearly prohibiting this drug in itself will not fix the problem. Perhaps the savings from delisting this drug could be more appropriately used to fund treatment programs across the province…

OxyContin limits lauded
Exceptional Access Program (EAP)
Ontario Drug Benefit: The Program
Oxycodone

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Choking Game Hazardous Among Teens

The Crime Victims' Institute at Sam Houston State University found that roughly 1 of every 7 college students surveyed at a Texas University have deliberately cut blood flow to the brain by choking themselves or by being choked by others in order to experience a brief euphoric high.
“The Choking Game, also known as the Fainting Game, Pass Out, or Space Monkey, is played individually or in groups and involves manually choking oneself or others, applying a ligature around the neck or a plastic bag over the head, placing heavy objects on the chest, or hyperventilating to attain a euphoric feeling. This practice has led to several suffocation deaths in Texas and across the country.”
Researchers surveyed 837 students in an attempt to find out more about the type of individuals participating in such behavior and to determine how this behavior was learned. They were also seeking out an understanding as to why people would do such a thing and in what context they would use this method to get high.

Results showed that…
  • 16% had played the choking game.
  • of those who had played the game, 72% had done so more than once.
  • males were more likely participants.
  • on average students started playing the game at 14 years of age.
  • 90% of those who played the game heard about it from their peers.
  • most admitted that others were present the first time they played the game.
  • curiosity about the effects of being choked was the primary motivation.
  • learning about the potential dangers resulting from playing the game deterred most of the non-participants.
A major problem with preventing this type of addiction is that there is no substance to purchase or ingest. It can produce euphoric highs like other types of drugs and can be just as deadly, however it can be much easier to conceal. Awareness of this kind of behavior should be acknowledged and a focus on prevention should really be put into place before more and more young people get involved in such a dangerous activity.

Moreover, clearly there could be catastrophic short-term effects from choking oneself on purpose and, although there are lack of studies, there could be detrimental long-term effects. Depriving the brain of oxygen could cause moderate to severe brain cell death, which could lead to permanent loss of neurological function ranging from concentration problems to loss of short term memory capacity to severe, lifelong mental disability to death.

Other terms for this behavior include: The Fainting Game, Riding a Rocket, Airplaning, America Dream Game, Black Out Game, Breath Play, Bum Rushing, California Choke, California Dreaming, California Headrush, California High, California Knockout, Choking Out, Cloud Nine, Dumbass Game, Dying game, Dream Game, Dreaming Game, Elevator, Flatline Game, Flat Liner, Flatliner Game, Funky Chicken, Harvey Wallbanger, Hyperventilation Game, Indian Headrush, Knockout Game, Pass-out Game, Passing Out Game, Natural High, Sleeper Hold, Space Cowboy, Space Monkey, Suffocation Game, Suffocation Roulette, Teen Choking Game, Rising Sun, High Riser, Tingling Game, Trip to Heaven, Rocket Ride and Speed Dreaming, Wall-Hit, Purple Dragon, Five second high.

Dangerous Choking 'Game' Prevalent Among Teens in Texas
Fainting game

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