Bright Yellow Triangles and Opioids

Health Canada now requires that prescribed opioid medications need to clearly indicate both on the bottle and in pamphlets a clear warning as to the potential for addiction and misuse. Doctors, researchers and others who study addictions and prescription misuse have suggested that this is an important step in preventing people from developing a dependency on this medication.

I have limited experience with taking medication. Other than my beta blockers for my heart condition and the very occasional antibiotic, I have managed to avoid needing to take prescribed medication. I therefore, may not be qualified to pass comment on a health initiative that may save lives. However, I cannot believe that sticking on a bright yellow triangle on a bottle of pills will cause anyone to be more careful. It is even less likely in my mind that anyone (with the exception of a few rather bored folks) will bother to wade through a notice, typed in incredibly small print, that has been stuck into the box. Individuals are not going to look at the label or read the pamphlet at 2:00 in the morning when they need to take another pill.

It is hard for me to believe that there is a single person living in Canada who is not aware that there is an ever increasing number of individuals who are addicted to opioids. I have to believe that every doctor is well aware of the risks and that the days of extended use of such medication without supervision and review is long past. I have to hope that every time such a medication is prescribed, the doctor has a serious and clear conversation with the patient. In my limited experience, even with my rather innocuous prescribed drugs, I don't get them until the pharmacist makes sure that I understand what I am getting. It would seem to me that if the medical community is doing its job (and I acknowledge that that is not always the case), there is sufficient opportunity for the patient to get all of the information about the drug and its dangers - if they want to hear it.

While doctors, in the post-modernist world may not be on quite as high as pedestal as they use to be, they are still seen as people who can deliver on basic cures and pain relief. In spite of the near epidemic rates of cynicism, we appear to still need to believe that there are people who will always give good advice so that we can get better. In spite of some overwhelming contrary evidence, many of us want/need to believe that the doctor is always right.  People who are in pain are more likely to nod their head when the doctor is talking, ready to agree to anything as opposed to discussing other less effective but safer options. If they ever have qualms about the medication they will just say -"well the doctor said it would help". Doctors may need to find ways of explaining the dangers differently or at the very least be able to spend more time with such patients on a more regular basis.

As the over prescription of such medications as opioids is at least in part the result of people wanting quick and simple results, so is the decision to solve at least part of the problem of abusing prescriptions by printing bright yellow labels on the bottles. It sounds good. It sounds as if someone is doing something. If such warnings stops two people from going down the path to addiction it is worth it. But  for Health Canada to assume that opioid abuse is the result of a lack of education profoundly misdirects the conversation of how and why addictions happen. This initiative places the onus on the patient, when that responsibility at the very least needs to be shared with those who are handing out the pills.