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Joan Gadsby
March, 2000


Obstacle 1: Lots of studies, little action.

Solution 1: Redirection of research funding toward action-oriented strategies, including professional help and supervision for chemically dependent persons, public awareness and education campaigns targeting doctors and consumers; i.e., through media, conferences, brochures, product inserts, pill hotline, etc.

Obstacle 2: Prescribing guidelines are not being followed; i.e., CPS, CMA, HPB, Drug Formulary, Therapeutics Initiative.

Solution 2: Recognition and acknowledgment of established guidelines by doctors, their regulatory bodies, the Health Protection Branch (HPB). Enforcement of guidelines through mandatory monitoring of doctors prescribing practices by the Colleges of Physicians and Surgeons. Disciplinary measures and mandatory education for doctors who do not follow guidelines. Use of independent, objective health watchdog organizations (i.e., Therapeutics Initiative). Maximum utilization of PharmaNet program and warning letters from the HPB to doctors.

Obstacle 3: Doctors' lack of ongoing education.

Solution 3: Compulsory educational upgrading of doctors (including testing) based on research findings replacing outdated drug treatments. Better education strategies from the College of Physicians and Surgeons, the CMA, and Pharmacare to encourage awareness and compliance, i.e. academic detailing.

Obstacle 4: Lack of legal accountability.

Solution 4: The development of government policy to assist those seeking restitution for medical malpractice associated with inappropriate prescribing; i.e., specific legal action fund with mandatory contributions by pharmaceutical companies and doctors - also utilizing fines levied against offending doctors. Legislation to ensure that health care practitioners are held accountable for improper prescribing.

Obstacle 5: Lack of objective information provided the consumer.

Solution 5: Mandatory product labeling and package inserts for prescription drugs with full disclosure of all potential side effects, dangers of long-term use, the intense withdrawal reactions associated and cognitive impairment with benzos; i.e., European system. Awareness building and educational initiatives; i.e., use of media, brochures. Government regulations on pharmaceutical advertising targeting doctors and consumers. Expansion of drug store role re: warnings with prescriptions; i.e., Shoppers Drug Mart model.

Obstacle 6: Incentive for pharmacists to follow up questionable prescriptions.

Solution 6: Incentive-oriented government initiatives which reward the implementation of flagging systems in pharmacies; i.e., B.C. Pharmacare program doubling pharmacists' dispensing fee for successful prescription intervention (after contacting the prescribing doctor).

Obstacle 7: High demand for the drugs due to doctor-induced chemical dependency; lack of alternatives for patients.

Solution 7: Provide health care coverage for psychologists (not just drug-oriented psychiatrists). Multifaceted educational process encouraging doctors to counsel re: whole health factors - lifestyle/diet/exercise; provide information, support and referrals to addiction specialists, detox facilities, naturopathic physicians, and community support and activity programs.

Obstacle 8: Lack of infrastructure, skill and knowledge surrounding safe withdrawal.

Solution 8: Education drives targeting doctors geared to better identification and recognition of benzodiazepine dependency, short- and long-term withdrawal syndrome, the dangers of sudden withdrawal. Need for well-trained doctors to provide medical supervision Explore UK model: doctors sending letters and information to patients at risk. Create accessible infrastructure for safe, supervised withdrawal; i.e., insured detox centres, (percentage of pharmaceutical sales/profits to be allocated to set up infrastructure); systemic acknowledgment.

Obstacle 9: Minimization and denial of the problem by government, drug companies, doctors.

Solution 9: Create awareness of socio-economic costs of drug dependent patients to the health care system, justice system, productivity and safety in the workplace, and road safety; i.e., car accidents. Encourage transition toward redirection of monies supporting current chemical dependency and its complications to strategies addressing and alleviating the problem.

Obstacle 10: Industry education is often led by those who will profit from excessive prescribing; i.e., drug manufacturers.

Solution 10: Provide and require issue of continually updated, objective prescribing guidelines from impartial regulatory bodies not profiting from the promotion of prescription drugs; i.e., CMA, Health Protection Branch, Therapeutics Initiative. Strict controls and independent approval of advertising, product literature. Expand BC's "academic detailing" program nationally.

Obstacle 11: Conflicting relationship between profit-motivated drug companies and research and development funding.

Solution 11: People before profit. Guidelines, conflict of interest regulations and code of ethics set for allocating drug manufacturers' contributions to research at Universities and for clinical trials to protect the public's health. Independent body directing research dollars. Well publicized and audited clinical trials fully accessible to the public.

Obstacle 12: Government's reliance on drug profits encourages drug-based health care - resulting in lack of insured alternatives not producing profit.

Solution 12: Acknowledge falsely economical "quick-fix" of drug treatments for normal emotional responses. Progressive systemic change encouraging human approach to wellness with long-term benefits. Provide insured alternatives: i.e., psychologists - allowing patients to avoid unnecessary, damaging drug therapies promoted by drug companies and doctors. Investigation of alternatives offered by naturopathic doctors and other holistic practitioners.

Obstacle 13: Lack of financial resources to rectify the problem.

Solution 13: Expose the waste of money linked to long-term benzo dependency; i.e., doctor's office visits, emergency services etc versus the short-term cost of assisting in recovery. Initiate the redirection of money by reducing consumption. Prevention equals savings.

Obstacle 14: Lack of coordinated, integrated effort by key stakeholders: doctors, pharmacists, pharmaceutical companies, academia, consumers. Lack of leadership and commitment.

Solution 14: Legislative, regulatory acknowledgment encouraging open communication between stakeholder groups focusing on prevention education and consumer protection. A central information/advocacy centre with an integrated approach to positive solutions Leadership and commitment.

"Addiction By Prescription" © Copyright March 2000 · Joan E. Gadsby

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