Ontario WCB approves use of OxyContin replacement

TORONTO (Canadian OH&S News)

The Workplace Safety and Insurance Board (WSIB) in Ontario has given the green light to OxyNEO, a replacement painkiller to the much-maligned OxyContin.

Purdue Pharma, makers of the drugs, discontinued OxyContin at the beginning of March. The prescription painkiller is used to control moderate to severe pain and contains oxycodone in a controlled-release tablet that provides 12-hour pain relief.

The new tablets are more resistant to breaking, crushing or chewing and, when in contact with water, become gel-like instead of dissolving, the company says in a statement. This makes it more difficult for the drugs to be abused through injections or snorting for the high it can cause.

“The WSIB wants to make sure workers are getting the best medical care and providing coverage for OxyNEO as a replacement for OxyContin is an important part of helping workers recover while reducing the risk of addiction or other complications,” says Donna Bain, vice-president of health services at the WSIB, adding that the cost of the drugs is very comparable.

In 2011 there were about 6,000 workers covered for OxyContin prescriptions — less than 10 per cent of all workers who have a drug bill paid by the WSIB, she says. “As information comes out about OxyNEO, because it’s new to the market, we want to make sure we stay on top of that, always with a view towards what is appropriate and safe for our population.”

Because the drugs are not interchangeable, workers who are covered for OxyContin use by the WSIB will have to get a new prescription, a situation that could cause problems for many workers already taking the drug, says Steve Mantis, secretary of the Ontario network of the Canadian Injured Workers Alliance.

“Many injured workers feel somewhat overwhelmed by how the whole system works. They’re taking these painkillers and they lose some of the initiative to problem solve things themselves,” Mantis suggests, leading to situations where workers have to find out at the pharmacy that the WSIB won’t pay for their drugs anymore, creating a period when a worker’s medication runs out before they can get another appointment with their doctor, leaving them without medication.

Too much focus on prescription drugs: alliance

Mantis argues that the WSIB and the medical profession are still focusing too much on prescription drugs and not on alternative treatments such as physiotherapy and massage therapy.

“The WSIB, it’s been a real battle over a number of years to get them to cover those types of therapies, where the prescriptions from the doctor are much easier to cover. That’s led to a greater reliance on OxyContin, Percocets, different painkillers and it doesn’t need to be that way,” he argues. “Maybe we’ve all gone a little bit too far in prescribing this type of medication.”

For their part, the Workers’ Compensation Board of Nova Scotia and WorkSafeBC will also be covering OxyNEO, though like the WSIB, the Nova Scotia comp board is also reviewing other options.

Nova Scotia has about 200 workers currently covered for OxyContin or OxyNEO, and while numbers were not available for British Columbia, WorkSafeBC spent over $1M in OxyContin prescriptions for 2010.