N.Ont overdose death should be red flag, expert says

Experts say switching patients from OxyContin to another opioid can be a challenge for doctors.

They say overtaxed family physicians may have inadequate or out-of-date training in pharmaceutical equivalents. They noted the overdose death of a northern Ontario man should be a red flag for primary care doctors who must switch patients from the now-discontinued drug OxyContin to another opioid to control their chronic pain.

The unidentified man had been prescribed OxyContin for chronic pain and the drug was covered under a health benefits plan. But because the intended replacement drug, OxyNeo, is not covered, the man's doctor switched him to another long-acting opioid.

University of Toronto addiction expert Dr. Meldon Kahan said doctors have access to tables that show equivalent doses for different drugs. But he said physicians are not always trained in how to use them properly.

Other long-acting opioids for chronic pain include morphine, which is about half as potent as oxycodone — the active ingredient in OxyContin and OxyNeo.

Two other opioids in the class, hydromorphone and fentanyl, are much stronger than oxycodone.

The drug given to the northern Ontario man was not identified.