Prescription Drugs Misuse

Are prescription drugs as safe as we think?

February 15, 2016

Prescription drugs, such as opioids, are usually prescribed to reduce pain and discomfort. In some cases, however, these prescription drugs are used incorrectly by patients, either knowingly or unknowingly.

Prescription drug abuse, or misuse, is linked to numerous health complications and may lead to an addiction, an overdose, or even death.

A growing concern in Canada, the issue of prescription drug misuse, or abuse, highlights a number of unanswered questions that CIHR-funded researchers are working hard to resolve.

Dr. Bernard Le Foll is a CIHR-funded researcher from the University of Toronto and the Centre for Addiction and Mental Health and the co-lead of the Canadian Research Initiative in Substance Misuse (CRISM). He is a clinician-scientist who received specialized training in drug addiction and cognitive therapy in France. His research aims to use various approaches, including genetic and brain imaging, to improve treatment of drug addiction.

Dr. Bernard Le Foll
Centre for Addiction and Mental Health
Photo courtesy of the Centre for Addiction and Mental Health (CAMH).

Audio – Interview with Dr. Bernard Le Foll (in French only)

Transcript

Mr. David Coulombe: Here is David Coulombe for CIHR’s Health Research in Action news. The Canadian Research Initiative in Substance Misuse is aimed at improving the health of Canadians who have a problem with the abuse of prescription drugs, the misuse of certain drugs or even an addiction. Prescription drug abuse is an urgent and complex health issue in North America. To discuss this issue, my guest today is Dr. Bernard Le Foll, co-principal investigator of the Canadian Research Initiative in Substance Misuse, and also a researcher funded by CIHR. Dr. Le Foll, hello and welcome to the interview.

Dr. Bernard Le Foll: Hello.

Mr. David Coulombe: So, what do we mean when we talk about the abuse of prescription drugs? Do you, perhaps, have an example to give us?

Dr. Bernard Le Foll: Of course. We are essentially talking about opiate medications. Opiate drugs are drugs like morphine, oxycodone or fentanyl. These are very powerful drugs used to reduce pain, but unfortunately they have a highly addictive potential. Therefore, a large number of subjects will lose control on the use of these opiates, which will result in their misuse.

Mr. David Coulombe: Precisely Dr. Le Foll, what kinds of health problems afflict people who abuse prescription drugs?

Dr. Bernard Le Foll: The major risk is the risk of an overdose, which will lead to respiratory failure that can cause death. Unfortunately, it is a phenomenon that is becoming increasingly common; here, we are talking about daily deaths in Canada.

Mr. David Coulombe: So, why is it important to conduct research in this area?

Dr. Bernard Le Foll: It is very important to do research in this area because it is not yet clear what is the most appropriate way to treat addiction to these opiates. We have treatments available; generally, the most frequently used are so-called substitution therapies, where we can use substances such as methadone or suboxone. These drugs have proved effective in very strict and highly controlled clinical trials that are not an exact reflection of the real world. So, it is very important that we assess how these products work in real life, and it is also important that we study how these drugs work for people who have developed an addiction to opiate drugs, because most previous studies have focused on users of opiates like heroin who do not have exactly a similar profile.

Mr. David Coulombe: In closing, tell us about the impact you want to have on patients with your research.

Dr. Bernard Le Foll: It is clear now that only a very small proportion of subjects who have developed an addiction to opiate engage in treatment and, more importantly, continue their treatment. Studies have shown that approximately 10% of users will persist in their opioid maintenance treatment. What we will try to establish in this study is what is the most effective approach in real-life situations patients encounter every day. We will compare the effectiveness of methadone, suboxone and, above all, of different modes of administration – short treatments or extended treatments with, significantly, the option given to the patient to choose the kind of approach he or she wants to take. Therefore, there will be a shared decision between the physician and patient – if the patient wants to continue the treatment, or quit after a few weeks.

Mr. David Coulombe: Dr. Le Foll, thank you very much and good luck with your project.

Dr. Bernard Le Foll: Thank you very much.

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