Posts Tagged "Drugs"


Often-abused codeine cough syrups to become restricted drugs

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Pharmacist Danny Tam with some of the codeine-containing cough syrups that will require a special type of prescription and will have to be locked up in vaults at pharmacies.

Francis Georgian / PNG

New rules will restrict access to some codeine-based cough syrups because their narcotic ingredient makes them addictive and subject to robberies and abuse.

Cough syrups like Dimetapp-C, Robitussin AC and acetaminophen with codeine are sedating pain relievers that have been marketed for many decades.

But Canadian research has shown adolescents often take them in greater amounts than prescribed in order to get high.

The College of Pharmacists of B.C. said there have been growing concerns about forged prescriptions and pharmacy robberies targeting the codeine formulations. There have also been cases in which such medications have been diverted by health professionals for personal use or to be sold on the street.

The College of Physicians and Surgeons of B.C. says the liquid cough preparations have been too easy to get.

As of Jan. 2, 2020, medications with higher potencies will be reclassified as controlled medications that require special, duplicate prescriptions. Preparations with very low concentrations of codeine will still be available from behind the pharmacy counter.

Dr. Heidi Oetter, the registrar of the College of Physicians and Surgeons, said that apart from being potentially dangerous, codeine cough medications have not been proven effective for anything other than some pain relief.

“The risk is simply too high for something that has no demonstrated benefits,” she said.

Under the new rules, doctors will have to fill out prescriptions on a duplicate pad to help prevent forgeries. Oetter said this should also prompt physicians to “give more deliberate thought” when they are writing such prescriptions. And pharmacies must also store cough syrups with codeine in time-delayed safes along with their other narcotics.

Chris Chiew, general manager of western Canadian pharmacy operations for London Drugs, said that “grab and go” thieves are far less likely to steal from stores with such vaults because they don’t want to wait around for them to unlock.

Chiew said the time delay safes, security cameras and guards in the London Drugs stores are all excellent deterrents. But he agrees with the colleges that other measures to prevent abuse and addiction may also be helpful.

He said that lozenges, drinking water or other fluids, and humid air are all good alternatives to cough syrup.

Because of the opioid epidemic, Health Canada followed the lead of the U.S. Food and Drug Administration and did a safety review of cough and cold products containing opioids like codeine and hydrocodone. It found “limited evidence” linking codeine cough syrups to opioid disorders and other harms in children. It also found, however, that there is little evidence showing any medical effectiveness of the products and so, as a precautionary measure, it advised against the use of such products in those under 18.

Chiew said he understands Health Canada has also been doing consultations on codeine products that do not require a prescription. It is possible those discussions could end up with a new standard that requires every medication containing codeine — in any format including pills and liquid — to require a prescription. Currently, for example, pharmacists can use their professional judgment to sell, without a prescription, acetaminophen with eight mg of codeine and some caffeine to offset the sedative effect.

A 2018 review of the effectiveness and safety of non-prescription medications containing codeine by the Canadian Agency for Drugs and Technologies in Health found there is evidence that low-dose codeine is effective for pain control or chronic cough when compared with placebo or non-opioid analgesics.

“However, the use of codeine can sometimes be less or similarly effective as non-opioid analgesics, while introducing the adverse effects, such as drowsiness, nausea, and constipation.”

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Acetaminophen elixir with 8 mg codeine phosphate syrup

PMS-acetaminophen with codeine elixir

Calmylin ACE

Covan syrup


Robitussin AC


Dimetane expectorant C

Teva-cotridin expectorant


Municipalities back Vancouver motion to push Ottawa for safer drugs

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Vancouver mayor Kennedy Stewart joined Dr. Patricia Daly, Chief Medical Officer for Vancouver Coastal Health, and Vancouver Fire and Rescue Service’s Capt. Jonathan Gormick to discuss the epidemic of drug-related deaths, at a press conference in Vancouver on Friday, September 6, 2019.

Jason Payne / PNG

Local governments across Canada will press the federal government to increase access to safer drugs, and declare a national health emergency in response to the fentanyl-driven overdose crisis, after a motion by Vancouver Mayor Kennedy Stewart was passed Friday.

Stewart’s motion, drafted with his overdose emergency task force, was approved by city council in July. Coun. Rebecca Bligh brought it to a Federation of Canadian Municipalities executive meeting this week.

The motion requires the federation to call on Ottawa to support health authorities, doctors, their professional colleges and provinces to “safely provide regulated opioids and other substances through a free and federally available Pharmacare program.”

The federation will also demand that the federal government declares a national public health emergency and provides exemptions to the Controlled Drugs and Substances Act, so that cities and towns can run pilot programs which prioritize a move toward a “safe” drug supply.

Stewart said Friday that there was some division among the federation’s membership over the motion but it passed following an effective speech by Bligh. He hopes it will “shift the national dialogue toward a safe supply” during the federal election.

He wants the substances act exemptions to allow health professionals with a non-profit organization to distribute diacetylmorphine, which local research has shown can be an effective treatment for chronic, relapsing opioid dependence.

Stewart met with Prime Minister Justin Trudeau two weeks ago and told him what Vancouver needs in order to replace fentanyl-tainted street drugs with a safer, regulated supply, he said.

“It was a private conversation but I can say that I left the conversation in good spirits,” Stewart said. “I was definitely heard and that was very important.”

Stewart said front line responders are fatigued, people are experiencing multiple overdoses and suffering brain injuries, and the city and province desperately need the federal government to step up.

“We’re going to have to take it to the next level here. We’re reducing overdose deaths but overdoses are increasing. Just not dying isn’t good enough,” he said.

“It’s got to be life and hope for people.”

Karen Ward, a drug user and advocate for others who use drugs, helped with the motion and was pleased the municipalities passed it.

“If a province is a bit hesitant, the idea is that this will give a city the power to take rapid action — and individual doctors, in fact,” she said.

“It’s a necessity to have safe supply at this point because the supply has become so contaminated everywhere.”

Ward said the federation can now send a clear message to Ottawa that municipalities want the power to treat the overdose crisis “like a real” public health emergency.

“This is one way to get them to talk about it, face it squarely and acknowledge this massive disaster, and say look, we need to change our (approach),” she said.

“We need to take it as seriously as possible. It’s a health issue. It’s also a justice issue.”

According to the federal government, there have been more than 9,000 apparent opioid-related deaths across the country since 2016.

Illicit drugs killed 1,533 people in B.C. in 2018 and 538 in the first half of 2019, according to the B.C. Coroners Service.

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B.C. becomes first province to force change to biosimilar drugs

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Biosimilars are manufactured after the 20-year patent period expires on biologics.

Francis Georgian / PNG

Starting today, over 20,000 B.C. patients with cancer or chronic diseases like arthritis, colitis and diabetes will have six months to transition to drugs that are similar to those they’re taking as the province becomes the first in Canada to stop covering some expensive, formerly patented drugs.

Health Minister Adrian Dix promised that no harm will come from the change that will initially save the government more than $96 million in its prescription drug program (PharmaCare).

The savings will be plowed back into the drug budget to allow for funding of drugs that have not yet been covered such as Jardiance, a medicine known as an SGLT2 inhibitor for diabetes. Another drug for psoriatic arthritis called Taltz will also be immediately available.

Since some of the soon to be phased-out government-funded drugs like Remicade have to be given at infusion clinics, Dix said there may be some inconveniences as patients find new locations. But patients will work with their doctors to make the switch to “biosimilar” drugs, which are the just-as-safe and effective copycat versions of brand name bioengineered drugs called biologics.

Biosimilars are manufactured after the 20-year patent period expires on biologics. They cost anywhere from 25 to 50 per cent less than the original biologic drugs which are said to be the single biggest expense for public drug plans like PharmaCare.

European countries have led the way in transitioning patients to biosimilar drugs, but Canada has lagged far behind.

In 2018, B.C. spent $125 million on Lantus, Enbrel and Remicade, three biologic drugs that treat chronic conditions such as diabetes, arthritis and Crohn’s disease.

“Biosimilars (like infliximab) are a necessary step to ensure PharmaCare provides existing coverage for more people and funds new drugs well into the future,” Dix said.

PharmaCare coverage for certain biologics will end Nov. 25. After that time, PharmaCare will provide coverage for the original drugs only in exceptional cases and they will be decided upon on a case-by-case basis.

B.C. has spent the last nine years studying the matter before making the decision. It consulted with physician and patient groups like the B.C. Society of Rheumatologists, endocrinologists, Doctors of B.C., Arthritis Consumer Experts, Canadian Arthritis Society, B.C. Pharmacy Association, Neighbourhood Pharmacy Association, regional health authorities, Health Canada, and the Patented Prices Medicine Review Board.

About 2,700 Crohn’s and ulcerative colitis patients will also be affected by the transitioning policy, but information for gastroenterology patients will be available in a month or two.

Rheumatologist Dr. John Esdaile said B.C. becomes an overnight Canadian leader with the cost-saving policy change.

“It’s a great day for B.C., for patients, for PharmaCare and for health care in general,” he said, noting that many European countries have had such a policy for 10 years with no evidence of detriment to patients. “I don’t know of any bad news,” said Esdaile, scientific director of Arthritis Research Canada, which has been “badgering” the province to enact such a change.

“For years, B.C has been spending money it doesn’t need to spend on expensive biologics instead of using biosimilars which I call biogenerics since they work just as well,” Esdaile said.

Cheryl Koehn, president of Arthritis Consumer Experts, said society will benefit from the new policy because coverage for other conditions and drugs will expand.


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‘We’re not all in gangs, doing drugs and bumming out of school’: Surrey students defend their city | CBC News

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When you spend an entire month back in high school, you hear a lot of stories.

Once the students get comfortable, they have no problem sharing their thoughts about anything and everything.

And the most common topic the students at Surrey’s L.A. Matheson Secondary School wanted to talk about? The unfair reputation that comes with being from Surrey. 

“We are not bad kids,” said Grade 12 student Samantha Czulinski, 18.

“We’re not all in gangs. We’re not all doing drugs and bumming out of school.”

Grade 12 student Samantha Czulinski says people need to work harder to truly understand what happens in Surrey. (Martin Diotte/CBC)

It’s a common sentiment in these hallways, but not just among students.

Like it or not, Surrey has struggled with reputation issues throughout its history. As a suburb which was traditionally lower on the socio-economic scale compared to Vancouver, stigmas have always been attached to the city and its residents.  

Struggles with gang violence has also exacerbated the perception and reputation of the city, but students here say it’s high time those misguided ideas are put to rest. 

Living and working in Surrey allows Matheson teacher Annie Ohana to see first-hand the impact the reputation has on her students.

Some students say they feel that coming from Surrey negatively impacts how they’re viewed. (Evan Mitsui/CBC)

“We all walk with a chip on our shoulders,” said Ohana, who teaches social justice.

“From a very young age, kids are very well aware that somehow our city is maligned.”

Ohana is concerned that sometimes students subconsciously parrot that narrative.

“If all someone does is point you out as negative or say you have a problem, that’s internalized and then often becomes a behaviour,” she said. 

“You think I’m bad? Well then I’ll show you I’m bad.”

Annie Ohana lives and works in Surrey and says she sees the impact of the city’s reputation on her students. (Martin Diotte/CBC)

Stereotypes and stigma

Grade 12 student Kunwar Sandhu has lived in Surrey for most of his life, and said he often feels the stigma is felt deepest when Surrey students are compared to those who live elsewhere. 

Sandhu, 18, recalled one law field trip that brought together students from different schools in the region. 

“All the kids from our class were coming up with creative questions,” he said. Meanwhile, students from other schools weren’t nearly as engaged, yet the Matheson students felt looked down on.

“We’re not worse than these kids, but we’re viewed as worse than these kids.That’s not fair at all.”

Kunwar Sandhu, who is in Grade 12, has lived in Surrey for most of his life. (Martin Diotte/CBC)

Sandhu is not the only one who’s felt the stigma in his family. 

“My brother got a full ride scholarship into UBC but he’s still viewed as thuggish because he comes from Surrey. It happens to most people who are here,” he said. 

“It’s crazy how people can go ‘Oh you’re from here? You look like this, you must act like this.'”

The hallways at Matheson are monitored during class. (Evan Mitsui/CBC)

Stigma in the hallways

The students say the stigma doesn’t just come from outside Surrey — it shows up in their hallways and classrooms, too. 

The Surrey School District has a program called Safe Schools that operate across the city. Trained liaisons monitor the halls during class to ensure students are safe and to look out for any suspicious activities.

Some students at Matheson point to this as an example of how their reputation as Surrey students has an impact on the way they’re treated. They say the feel that hallway monitors are policing them throughout the day. 

“If I’m outside of the classroom for two minutes, going to the washroom, I feel like it’s so unnecessary to attack every student who walks through the hall [during class],” said Grade 11 student Jasmeen Saini.

“We’re not rats infesting the school.”

Surrey’s school district is one of the fastest growing in the region. (Evan Mitsui/CBC)

Growing city offers means the chance for renewed reputation

Surrey is the second-largest city in B.C., with 800 new residents moving in each month, and its school district is one of the fastest growing in the region.  

That’s having an impact on how Surrey is seen, according to Matheson principal Peter Johnston.

“The perception of Surrey and LA Matheson is slowly changing in the minds of people who end up coming out here,” Johnston said.

“They realize we aren’t a small and rural town anymore and our facilities and school districts are second to none.”

L.A. Matheson is located in inner-city Surrey. (Evan MItsui/CBC)

But for that perception to continue changing, it’s also up to the students. 

“It’s part of our responsibility to get these students ready for the modern world to help change that narrative,” Johnston said.

“The students have to take some responsibility for that too.”

For students like Sandhu, they have a clear message to the rest of B.C. about Surrey’s reputation: 

“Just because I’m from somewhere else, you think you’re better than me? It’s just not cool.”  

This story is part of a series called Matheson, examining the lives of students at L.A. Matheson Secondary School in Surrey, B.C. CBC journalist Jason D’Souza was given unparalleled access as he spent a month embedded at the high school in order to hear unfiltered stories of students today.

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Jail drugs: Ex-prisoner says no addiction help as life outside loomed

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VANCOUVER — Memories of vomiting, diarrhea and unrelenting stomach pain as he withdrew from opioids in prison had Rob MacDonald repeatedly asking for addiction treatment before he left a maximum-security facility but despite dozens of formal complaints, he says he didn’t get any help.

“I was thinking, ‘Wow, I can’t believe I’m going out onto the street with this addiction,”‘ MacDonald said recently, a week after being released on supervision from the Atlantic Institution in Renous, N.B., his fourth facility in over a decade behind bars.

MacDonald, 41, said he feared his 15-year opioid addiction would cause him to returned to crime while using illicit drugs on the outside so he tried desperately to get treatment from the federal prison service.

“I put 150 requests in, probably 70 complaints, for a 15-month period, trying to tell them, ‘Put me on it. I need it before I get out. I want to get help, I don’t want to go back into the community in a high-risk situation, I don’t want to re-offend,’ ” he said from Halifax, where he lives in a halfway house.

He said he complained to the warden and then appealed to the commissioner of the Correctional Service of Canada. One of his complaints to the commissioner was upheld but he said he was placed on a wait list because there was a limit on the number of inmates receiving treatment.

When he was incarcerated at Agassiz’s Kent Institution between 2017 and 2019 for drug-related offences and robbery, MacDonald said debilitating withdrawal symptoms had him seeking potentially deadly fentanyl-laced drugs that were smuggled into the prison.

“At least eight guys died in the 17, 18 months I was at Kent,” he said.

The Correctional Service linked MacDonald to a clinic in Halifax upon his release nearly two weeks ago and he is now prescribed the opioid substitute Suboxone. But he said he should have received the medication in prison as part of the agency’s treatment program, which also includes methadone, so he could focus on finding a construction job to get his life back on track.

'At least eight guys died in the 17, 18 months I was at Kent,' Rob MacDonald says of the Agassiz maximum security penitentiary.

‘At least eight guys died in the 17, 18 months I was at Kent,’ Rob MacDonald says of the Agassiz maximum security penitentiary.

Darren Calabrese /


Ivan Zinger, Canada’s ombudsman for offenders, said the Correctional Service has failed to provide adequate addiction treatment, programs and staff at a time when more drugs are contaminated with fentanyl.

“I think when you’re dealing with a large inmate population that has such a long history of substance abuse you should be providing an awful lot more treatment and programming in addition to opioid substitution therapy,” said Zinger, who called for the reallocation of funding to provide those services.

“It’s unclear to me why the budget has remained the same and decreased in the past when clearly the number of incidents is increasing,” he said of overdoses that caused 41 deaths between 2010 and 2018.

Zinger said programs such as counselling are provided just before offenders are released instead of throughout their incarceration.

“That’s a problem when you have a highly addicted inmate population that has a lot of time on their hands and are in sometimes difficult conditions of confinement. They will find ways to bring in drugs.”

The Correctional Service said in a statement that 66 per cent more prisoners have accessed treatment in the last two years, but a jump of 115 per cent has been recorded in the Pacific region, where the opioid crisis is most acute.

It did not respond to requests for information on whether its budget will be increased to meet the demand for more treatment.

Kent Elson, a lawyer for an offender at Joyceville Institution in Kingston, Ont., said the Correctional Service did not accommodate his client’s disability of addiction so he filed a complaint with the Canadian Human Rights Commission last November.

Rob MacDonald, who was released last week on supervision from the Atlantic Institution maximum security facility in New Brunswick after a 10-year stint in four facilities including Kent Institution in Agassiz.

Rob MacDonald, who was released last week on supervision from the Atlantic Institution maximum security facility in New Brunswick after a 10-year stint in four facilities including Kent Institution in Agassiz.

Darren Calabrese /


Elson said his 50-year-old client, who is serving a four-year sentence, had been on methadone but alleges the medication was withheld without explanation for five days when he was transferred from another facility in November 2017.

“He needed medical help and he got forced, cold-turkey withdrawal in a feces-smeared segregation cell and cruel mistreatment from guards. And it was so unbearable that he tried to kill himself three times,” Elson said from Toronto.

While Correctional Service guidelines state a doctor is required to interview offenders before they are involuntarily tapered or cut off from methadone or Suboxone, Elson said his client was not seen by a physician.

“This whole experience was incredibly traumatic and he ended up with PTSD,” he said.

“The impact on him was terrible but everybody wins if prisoners get the right treatment. Suffering from PTSD is not going to make them easier to integrate back into society.”

The Correctional Service did not respond to a request for comment on the human rights complaint filed by Elson or another from the Prisoners’ Legal Services. The B.C. group’s complaint was filed in June 2018 on behalf of offenders who accused the Correctional Service of discriminating against them.

Nicole Kief, an advocate for the group, said about 100 inmates reported three main concerns: long wait lists for treatment, being cut off Suboxone after false accusations of diverting it and not receiving addiction counselling.

“Of the people that I’ve talked to there has been a real sense of urgency, with people calling me and saying, ‘I’m worried about dying,”‘ she said.

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London Drugs family gives $6.5 million toward new St. Paul’s Hospital

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The cardiac centre at the new St. Paul’s Hospital will be named the Tong Louie Cardiac Wing in recognition of a $6.5-million donation from the Vancouver family that owns London Drugs, it was announced Tuesday.

Two charities — the London Drugs Foundation and the Tong and Geraldine Louie Family Foundation — are contributing the sum for the new hospital near Main Street and Terminal Avenue. The 124-year old hospital on Burrard Street is to be demolished after construction on the new hospital ends, in 2024 or later.

Brandt Louie speaks as St. Paul’s Foundation announces donations from the London Drug Foundation and the Louie family at Wall Centre Hotel in Vancouver, BC, Oct. 30, 2018.

Arlen Redekop /


“As a 115-year-old B.C. owned and operated family company, we are proud of our lengthy history of giving back to the people of this province,” said Brandt Louie, chair of London Drugs Ltd.

“This is a proud moment for our family and we are honoured to be part of the bold, bright future of the new St. Paul’s.”

Louie said in a statement that family matriarch Geraldine Louie received exceptional care at St. Paul’s towards the end of her life and while being treated for congenital heart disease.

An image of the proposed Tong Louie Cardiac Wing at the St. Paul’s Hospital site in False Creek.

Arlen Redekop /


The donation will be used for an in-patient wing of the hospital that will be built on the False Creek Flats. The wing will be located close to imaging and diagnostic areas, operating rooms, outpatient clinics, cardiac research labs and medical offices. The design is meant to allow patient treatment and research side-by-side.

Dr. Sean Virani, the physician program director for the Heart Centre, said the donation will help recruit cardiologists and  surgeons and expand care for patients. St. Paul’s is the only hospital in B.C. that performs heart transplants. Under pioneering interventional cardiologist Dr. John Webb, it has become world-famous for minimally invasive heart valve surgery.

Construction of the new hospital is not expected to begin for a few years as the City of Vancouver rezoning process is expected to take more than a year and soil remediation will require extensive work.

The B.C. government has not yet announced approval of the more than $1 billion business plan, but numerous announcements from the hospital foundation would suggest the project — first announced by the former Liberal government — will go ahead. Just over a year ago, health minister Adrian Dix said the redevelopment of St. Paul’s on the False Creek flats was one of his priorities.

It is expected the sale of the lands under the existing hospital will fund the construction of the new hospital, to which Jimmy Pattison has already pledged $75 million. While the hospital itself will still be called St. Paul’s, the campus will be called the Jim Pattison Medical Centre.

On Monday night, the foundation held an invitation-only gala event for past and future donors.

St. Paul’s Foundation announces donations from the Louie family, some of whom are pictured here (left to right) Gregory, Kurt, Brandt and Stuart, at Wall Centre Hotel in Vancouver, BC, Oct. 30, 2018.

Arlen Redekop /


Chronology of the site where new St. Paul’s Hospital will be built:

1912-20: False Creek drained to make way for construction of railway lines. A Great Northern Railway station is built on the site, with a Canadian National Railway station, which still stands, built to the south.

1930: Great Northern Railway freight sheds occupy the south end of the site. Businesses along Prior Street include Canadian Junk Co. and a junk storage warehouse.

1956: The site is occupied by Finning Factory and the Great Northern Railway freight shed. Prior Street businesses include the United Fruit Ltd., Canadian Junk and Great West Smelting.

1966: Great Northern Railway is moved and the train station is torn down.

2000: Schroeder Properties and ING Realty Partners purchase the site for $22 million from Trillium Corp., hoping to develop the site for the high-tech and dot-com industries.

2004: A Providence Health Care-affiliated entity buys 18.5 acres from Schroeder Properties and ING Realty Partners for just over $24 million. The entire amount is financed with a bank loan.

2010: Gravel is added to reinforce and level the site for use during the 2010 Olympic Games as a parking lot for the buses that transport people between Vancouver and Whistler.

2010: The B.C. government acknowledges it has paid millions in municipal taxes to hold the site for the future hospital.

2015: Providence Health Care, which manages St. Paul’s Hospital and numerous other Catholic health facilities, announces a new $1.2 billion hospital on the new site and the eventual demolition of the old hospital in the West End.

2017: Vancouver billionaire Jimmy Pattison announces a $75 million donation to the new St. Paul’s. NDP health minister Adrian Dix says the new hospital is a high priority.

2018: Fundraising, rezoning and public consultation process begins in earnest for the new St. Paul’s.

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