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    Health Canada's prescription opioid stickers will warn of addiction risk 
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    Health Canada's prescription opioid stickers will warn of addiction risk
    CBC
    May 2nd, 2018

    Health Canada is making warning stickers and patient handouts mandatory with all dispensed prescription opioids dispensed, and the final regulations were published Wednesday in Canada Gazette.

    The bright yellow warning sticker will say the opioid medication can cause dependence, addiction and overdose.

    The stickers will be applied to each container that's given to the patient.

    The handout will inform patients about:

    - The signs of opioid overdose.
    - Warnings such as not to share the medication.
    - Always store the medication safely out of reach of children.
    - It will also advise of other serious warnings and potential side-effects.

    The mandatory warning sticker and the patient handout will be distributed starting in October.
    Read the full story here.

    Read the new regulations here.

    The sticker and handout:

    NSFW:


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    Quote Originally Posted by Health Canada
    Babies born to mothers taking opioids may develop life-threatening withdrawal symptoms.
    This is utter nonsense. Even if you believe the flimsy evidence that babies born to opioid-using mothers experience withdrawal symptoms at all, it is certainly not a life-threatening condition. In fact, the babies tend to do quite well if they and their mothers are treated like everyone else at the hospital.

    Alarmism like this is just going to lead to more stigmatization of opioid-using mothers and encourage behaviour that is actually dangerous for an unborn child, like a mother on a regular prescription stopping cold turkey and going into withdrawal.
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    Quote Originally Posted by S.J.P. View Post
    This is utter nonsense. Even if you believe the flimsy evidence that babies born to opioid-using mothers experience withdrawal symptoms at all, it is certainly not a life-threatening condition. In fact, the babies tend to do quite well if they and their mothers are treated like everyone else at the hospital.

    Alarmism like this is just going to lead to more stigmatization of opioid-using mothers and encourage behaviour that is actually dangerous for an unborn child, like a mother on a regular prescription stopping cold turkey and going into withdrawal.
    Everyone should be treated appropiate and with respect regardless of whats their medical condition.

    CT when pregnant is very dangerous for an unborn child and may have a fatal outcome. There are other treatments that would be better for the mother and the baby.

    I wanted to reply on your comment abt that is utter nonsens that babies experience wd symptoms and that its not lifethreatning.
    I personally know for a fact that it can happend. A friend of mine who were using prescription opiates, also during pregnancy, gave birth to a baby whith severe wd's. The baby died!
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    NAS can be life threatening, but there is next to no reason it should be. Generally opioids present in breast milk are enough and in severe situations the baby can easily be treated for NAS in the hospital’s. Generally it seems babies have trouble with this because of how we deal with it on systems levels, not something inherent to the pharmacology of opioid use/dependency.
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    Quote Originally Posted by moscatel View Post
    I wanted to reply on your comment abt that is utter nonsens that babies experience wd symptoms and that its not lifethreatning.
    I personally know for a fact that it can happend. A friend of mine who were using prescription opiates, also during pregnancy, gave birth to a baby whith severe wd's. The baby died!
    I'm sorry that that happened to your friend. How do you know, though, that the baby died from opioid withdrawal? Studies have been done that show that NAS severity is not correlated to a mother's methadone dose. In the 1970s, before "NAS" was a thing, babies born to heroin-addicted mothers were relatively fine.

    Opioid-taking pregnant women are extremely stressed out, given how much they are demonized by society and made to feel like they are terrible mothers-to-be. The negative effects of stress on unborn children are very well studied.

    You know what study I would like to see? Take a collection of expectant mothers who have been in extremely stressful life situations for the past nine months, and who are generally malnourished and chronically sleep-deprived. Then, take a collection of healthy, happy mothers who have been consistently taking prescription opioids and have been told that all is fine, that their babies will be fine, that they are doing nothing wrong. Now, have all the doctors at the maternity ward told that every mother had been abusing opioids, and see how frequently NAS is diagnosed. I would bet good money that the first group of babies would be diagnosed with NAS more frequently than the second.
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    ^outstanding post SJP! We are lucky to have you around
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    Quote Originally Posted by S.J.P. View Post
    I'm sorry that that happened to your friend. How do you know, though, that the baby died from opioid withdrawal? Studies have been done that show that NAS severity is not correlated to a mother's methadone dose. In the 1970s, before "NAS" was a thing, babies born to heroin-addicted mothers were relatively fine.

    Opioid-taking pregnant women are extremely stressed out, given how much they are demonized by society and made to feel like they are terrible mothers-to-be. The negative effects of stress on unborn children are very well studied.

    You know what study I would like to see? Take a collection of expectant mothers who have been in extremely stressful life situations for the past nine months, and who are generally malnourished and chronically sleep-deprived. Then, take a collection of healthy, happy mothers who have been consistently taking prescription opioids and have been told that all is fine, that their babies will be fine, that they are doing nothing wrong. Now, have all the doctors at the maternity ward told that every mother had been abusing opioids, and see how frequently NAS is diagnosed. I would bet good money that the first group of babies would be diagnosed with NAS more frequently than the second.
    It is so sad. Still cant believe it.
    I know only from what the parents told me. They said that the baby were showing all signs of withdrawels for the few days he lived. The drs told them it was wds that was the cause of death and the parents thought so too based on what they could see of signs and symptoms. They also got a full autopsy.

    as i understand from what they told me its caused by the baby getting the drugs by the umbillicalcord. When this is cut of after labour the baby who has been influenced by opiates during moms pregnancy is going CT since he is not getting anymore from his mother. also they are often underweight and born premature. Which makes them not as strong as they could have been to fight wds (or other illnesses.) after speaking with the parents so I do believe that death from opiate use by the mother is possible but not hopefully very common. If treated properly most of them will be okay.

    may I ask if you know someone who went through the same or simmilar as my friends? You write abt mothers who are demonized and I was wondering if you know this from personal experience?or are you generalize?
    reason for me asking is that my friends actually experienced the total opposite. And its also in my opinion that most of the healthcareworkers here treat people with empathy and respect. There are ofcourse some exeptions.
    After this tragedy happend I have been trying to be there for them. And we have been talking alot. I asked the mother spesifically how she had been treated and I was pretty surprised by her answer.

    she has been on painmedication for abt 10-12 years. When pregnant her pain increased and it spread. When she told her GP abt this he had her examined. He then put her on oxycodon instant release in addition to codein. She didnt have to beg for it.
    He also knew she was pregnant abt 2 months.
    He used the exact same arguments that you say. That its not healthy for the child that mom is stressed out and in pain. Therefor it should be treated.

    She had a planned c section. The hospitalstaff knew that she had been on opiates during prgnancy. They gave her extra followups before admition due to that. To make sure everything was okay. And she was educated in what to may expect if the baby were showing signs of wd's and so forth.

    she said that they were always treating her with care and respect. Not once she felt like she was doing something wrong. So she had a good pregnancy with no stress or demonizing.
    when the baby was having wd's he was also treated properly according to protocoll including morphine. The staff never showed any signs of blaming her. They knew she had a painfull condition which had to be treated.
    they did what they could and also gave them followups afterwards. Both parents express that they were treated with empathy.

    I always thought that people are to biased against drugusers both those who are on prescriptions and those who get it illegal. Without knowing to much abt it
    I learned from this that I myself in fact actually are the one who often are biased against others that are not using. Thinking that everybody are, demonizing those who are using. Fortunately now I know there are some who dont. Lesson learned..

    Quote Originally Posted by toothpastedog View Post
    NAS can be life threatening, but there is next to no reason it should be. Generally opioids present in breast milk are enough and in severe situations the baby can easily be treated for NAS in the hospital?s. Generally it seems babies have trouble with this because of how we deal with it on systems levels, not something inherent to the pharmacology of opioid use/dependency.
    When saying that opiate wds do not exist and in case they are not lifethreatning I just wanted to chear my personal experience with this. It should not happen but it do.

    If we lived in utopia and no one did drugs there would be no wds or nas. So it has to do with pharmacology of opioids which in the end will produce wds. Some babies will be born premature and/or not strong enough to fight of complications
    totally agree abt treatment on system levels. I do believe there generally are lack of competent and educated personell and hence there are undertreatment and maybe mistreatment.
    there are also a lack of treatmentoptions for the mother to be. At least were I live. But I think its a worldwide problem.
    CT is not an option. There should be other options availeble for the mother to safely slow taper under medical observation. Atleast they should be given that choice. And in addition they should be presented with non pharmacologual paintreatment options.
    I believe that some also hide their druguse due to the way they hear some has been treated by the system when they come forward.

    I saw a documentary abt this. I believe it was a dr from the usa. He and his co workers are doing serious research on how to safely help pregnant drugusers get clean during pregnancy. They were also educating other drs. They aim for an international protocoll. They already helped some women who came forward and told abt their experience and suxess.
    we need more of that. Non biased and well educated healthworkers. I believe that most pregnant women wish to reduce or get clean. But it is as hard for them,if not harder, like it is for the rest of us. Espesially if they use to,treat pain. But if they want to try we need to have the help ready to give.
    Last edited by toothpastedog; 05-05-2018 at 07:00. Reason: Merge
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    The point of my earlier comment is that pregnant women who are opioid users are so incredibly stigmatized and marginalized in most communities and tend to receive substandard care.

    There is no reason short of the war on drugs and stigma that women who use opioids don’t receive better care. It happens of course, NAS and drug use during pregnancy is serious business, but in particular when it comes to opioid use it is not particularly difficult for (most) situation with proper support.

    I think we agree more or less though. My point was just that pharmacology of opioids is less what the issue is here, because it is technically fairly easy to manage with proper medical care. Of course there are exceptions, but as a general rule there isn’t any reason outside stigma and draconian and inhumane policies related to prohibition and the war on drugs.

    Pregnant opioid users who are provided with the necessary psychosocial and pharmacological support who have babies that pass away in connection with their drug use are the exceprion to the rule. Not denying it happens, but with adequate care it is not the norm. The frustrating thing is many, many women in many, many communities simply don’t have access to the necessary support.

    What doc did you mention? I’d very much like to check it out if you can remember the name.
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    Quote Originally Posted by toothpastedog View Post
    The point of my earlier comment is that pregnant women who are opioid users are so incredibly stigmatized and marginalized in most communities and tend to receive substandard care.

    There is no reason short of the war on drugs and stigma that women who use opioids don’t receive better care. It happens of course, NAS and drug use during pregnancy is serious business, but in particular when it comes to opioid use it is not particularly difficult for (most) situation with proper support.

    I think we agree more or less though. My point was just that pharmacology of opioids is less what the issue is here, because it is technically fairly easy to manage with proper medical care. Of course there are exceptions, but as a general rule there isn’t any reason outside stigma and draconian and inhumane policies related to prohibition and the war on drugs.

    Pregnant opioid users who are provided with the necessary psychosocial and pharmacological support who have babies that pass away in connection with their drug use are the exceprion to the rule. Not denying it happens, but with adequate care it is not the norm. The frustrating thing is many, many women in many, many communities simply don’t have access to the necessary support.

    What doc did you mention? I’d very much like to check it out if you can remember the name.
    Yes I think we both agree. My english writing may not be fluent enough and may lead to misunderstanding. I am not saying that pregnant women are not stigmatized. They sure are. I was just saying that not everybody is. Like my friends. And I was surprised by that. And made me realize that I actually have been biased against our healthcare system.

    I have been paying a lot of attention to the us and the war on drugs and opioidcrisis. For me it looks like it has had unwanted sideeffects. Scaring drs from giving proper treatment. And also raise people's negative attitude towards people who use opiates. And pharmacies refusing to fill prescriptions.
    It surprised me to read that there are us laws stating that a pregnant woman who uses opiates is a childabuser. Instead of helping theese women they are getting punished. This is not helping tne babies at all. Therefor some of them were rubbing drugs on the babies gums to prevent wds during their hospitalstay to prevent punishment.

    there has been litle to non attention towards opioidcrisis here in europe. At least in my country. Alot of our healthcare professionals do not even know to much abt the crisis when I,ask them abt it. And we dont seem to have as huge of a problem yet anyway. But that may change.

    Having a healthcare system which is runned by our goverment and not private may also contribute to a better stander of care forexample for those who are pregnant. And infants with wds. They have a right to be given necessary and equal treatment. And pharmacies can not deny to fill a legal prescription. Every hospital has to follow national protocolls. They cant legally refuse to treat pasients. But they still can express negative attitudes which they often will I presume.

    the doc was on tv a while ago. And the name of it where in my language and which I cant remember now. But I googled it and think I found the dr and also an article abt it. I added the link belowe.

    This is what I was talking abt. Most pregnant women want to become clean for their babies but when they do we dont have the help ready to give. Due to biases, lack of knowledge and education I think. And this show the stigma you were talking abt. Like the woman here. She and many others have been facing demonizing when seeking adequit treatment and also has been told that getting of opiates will kill the baby. The result is that they still use during pregnancy and babies may have to suffer through wds. Eventhough it may be seldom fatal if treated properly it will still be painfull for the babies. And I dont think we fully understand possible long term effects for the children. How it may will effect them later on in life.
    The drs who still believe that pregnant opiateusers are beyond help is the reason that the stander of care is still inadequit.
    When there in fact exist a safe way to help them. This dr also used to be biased based on outdated research. When he finally looked past his biases and into it he found a way to help them. He seems compassionate and determind. Hopefully his research will change the treatmentoptions for the better.

    https://edition.cnn.com/2017/05/05/h...ncy/index.html
    Last edited by moscatel; 05-05-2018 at 16:53. Reason: put in the correct link
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    Thanks mo!

    Great article! The crazy thing is that they have found including children and family in treatment makes treatment far more successful. I have to find the study, but iirc there was some very compelling research from Australia on this.

    Treatmen that allows the family to stay together, especially for single moms, seems like such a good idea, removing the childcare and separation issues, as well as preventing placing the child in foster care system or whatever.

    Too bad most treatment centers are more about making money than treatment outcomes, but that’s like in America and our highly unregulated recovery industry.
    Last edited by toothpastedog; 05-05-2018 at 16:58.
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    Youre welcome��
    please let me know your opinion on the article when you have been reading
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    I liked it. It painted a very clear picture of a really fucked up aspect of our reality. Opioid use and reproductive health is a serious issue, but it seems like we are mostly dealing with it via the criminal justice system as oppose from a healthcare perspective prioritizing the wellbeing of mother and child.

    But that is still the norm for the US

    This addresses some of that, but I’m still hunting for the paper I was thinking of
    https://www.opensocietyfoundations.o...n-20160928.pdf

    And https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4071056/ (see section in Integrated Treatment)

    Still looking
    Last edited by toothpastedog; 05-05-2018 at 17:14.
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    Quote Originally Posted by toothpastedog View Post
    I liked it. It painted a very clear picture of a really fucked up aspect of our reality. Opioid use and reproductive health is a serious issue, but it seems like we are mostly dealing with it via the criminal justice system as oppose from a healthcare perspective prioritizing the wellbeing of mother and child.

    But that is still the norm for the US
    well said! Spot on! Those sentences summarize it all!
    hopefully this dr and his co workers will contribute to change the norm.

    when it comes to haveing the family together for support its not surprising that suxess increase. Please send me the link if you can find it.
    Like for other addicts who are encoruaged to get a supportsystem. Why the system wont do the same for pregnant women beats me!
    Its crucial for those who are pregnant as they have to struggle with additional issues like their concern for their baby and loosing custody.
    I think family support takes away a lot of the additional concerns that theese pregnant women have to deal with in addition and hence they can put more of their focus on recovery which again increases suxessrate. And also makes it easier for the other children they may have. And by bringing in other familymembers they will be more educated what addiction is. And society may start to change its attitude.

    it is sad that the recovery industry is all abt short term money. In the long run the whole society would gain from more people being suxessfull in recovery.
    maybe americans would be better of if the qliniques were runned by goverment and not private like we have here? Then it wouldnt be all abt money and profit anymore...just wondering..

    Quote Originally Posted by toothpastedog View Post
    I liked it. It painted a very clear picture of a really fucked up aspect of our reality. Opioid use and reproductive health is a serious issue, but it seems like we are mostly dealing with it via the criminal justice system as oppose from a healthcare perspective prioritizing the wellbeing of mother and child.

    But that is still the norm for the US

    This addresses some of that, but I?m still hunting for the paper I was thinking of
    https://www.opensocietyfoundations.o...n-20160928.pdf

    And https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4071056/ (see section in Integrated Treatment)

    Still looking
    didnt see your edit before posting the last. Thank you for the links
    Last edited by toothpastedog; 05-05-2018 at 19:11. Reason: Merge
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    Quote Originally Posted by moscatel View Post
    may I ask if you know someone who went through the same or simmilar as my friends? You write abt mothers who are demonized and I was wondering if you know this from personal experience?or are you generalize?
    This is not my personal experience, but my opinion largely derived from what I see from the news media and what I know about the laws that criminalize expectant mothers who use opioids in the United States. I know that this is not the case everywhere, thankfully.
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    Quote Originally Posted by S.J.P. View Post
    This is not my personal experience, but my opinion largely derived from what I see from the news media and what I know about the laws that criminalize expectant mothers who use opioids in the United States. I know that this is not the case everywhere, thankfully.
    I see that your country is canada. may I ask how it is there? Regarding the law and treatment options?

    i believe that the dr who wrote the textbook abt painmedicine that was sponsered by purdue pharma is a canadian. The textbook called managing pain was used for educating drs up till abt 2010 I think.
    His name is Dr. Roman Jovey.
    Has the fact that he is a canadian had any influence on the canadian healthcare system regarding treatment?
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    Quote Originally Posted by moscatel View Post
    I see that your country is canada. may I ask how it is there? Regarding the law and treatment options?

    i believe that the dr who wrote the textbook abt painmedicine that was sponsered by purdue pharma is a canadian. The textbook called managing pain was used for educating drs up till abt 2010 I think.
    His name is Dr. Roman Jovey.
    Has the fact that he is a canadian had any influence on the canadian healthcare system regarding treatment?
    I think it is a lot better here than in the United States when it comes to the treatment of opioid-using mothers, although I am sure that it is no panacea. We certainly do not have laws criminalizing them and mandating the confiscation of their children.

    I am not familiar with Dr. Jovey so I cannot comment on his influence on pain-medicine prescription practices in Canada. I think, in general, that prescription practices here have followed those in the United States. We have the the second-highest per-capita opioid prescriptions in the world, after the U.S.
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    ^as a general rule treatment is more accessable in Canada; only caveat would be their indigenous populations (although the US has the same situation with theirs). The south really fucks up our track record...
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    Quote Originally Posted by S.J.P. View Post
    I think it is a lot better here than in the United States when it comes to the treatment of opioid-using mothers, although I am sure that it is no panacea. We certainly do not have laws criminalizing them and mandating the confiscation of their children.

    I am not familiar with Dr. Jovey so I cannot comment on his influence on pain-medicine prescription practices in Canada. I think, in general, that prescription practices here have followed those in the United States. We have the the second-highest per-capita opioid prescriptions in the world, after the U.S.
    Glad to hear that canadian mothers to be are treated well and not like criminals.

    In general, a lot of people, like myself, start out our addiction with legal prescription painkillers. I was reading that this is espesially true for females,who statistically, tend to suffer from more pain.

    I was thinking that a lot of theese women will also become pregnant. Its somewhat a paradox, dr's allowing, such high level of prescriptions, and then they have such low "willingness" responsebillity or refuse to treat properly those who they get addicted and that are the most vournable of all, mother and child.

    I enclose a youtube link. Its from canada. A program called global calgary. They talk abt canadians dont get the help they need. Couldnt find a newer one with Dr. Jovey. He speaks at 1:30 minute
    https://youtu.be/5NzAy68O3Rs
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    It still depends who you are in Canada. Some groups in particular still have very little access to quality treatment.
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    These stickers are literally a bandaid on a huge, huge problem that the government is only slowly addressing.

    They have photos on cigarette packages of people's faces rotting off and dead fetuses... it's not stopping addicts. You think you're going to stop complex opiate addiction with these fear mongering stickers?

    The government is so talented at throwing money at non-sense.
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    Pregnancy is the worst time to get off opiates. It's very important while pregnant that your opiate intake be stable. Having a baby born opiate dependant isn't ideal, but opiate withdrawal can quite easily cause a miscarriage so it's still a lot safer for the mother to be on opioid substitution therapy for the pregnancy then ween the baby (or ideally both mother and child) off after delivery.

    It really can't be stressed enough, people who pressure pregnant women to go cold turkey are being totally reckless and irresponsible.
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    Quote Originally Posted by toothpastedog View Post
    It still depends who you are in Canada. Some groups in particular still have very little access to quality treatment.
    I think that is true for a lot of the countries. Makes me wonder what the people who are in charge thinks. They obv dont know to much abt addiction.
    When not offering decent treatment to all those in need they create an even bigger sosio problem and additional costs to society.
    seems like they dont really care as long as its not comming out of their budget.
    That is until election is comming up....

    like foreigner writes..a sticker will not make an addicted pregnant woman stop her druguse. That is a waste of money.
    If they would rather give her acsess to proper treatment they would proberly have saved a lot of money in the long run.not to mention QOL for both the mother and the child. Which cant be given any pricetag at all
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    they should have a warning that says do not stop taking cold turkey, as it is physically addicting
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    #24
    Bluelighter Pickledlemons's Avatar
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    The stickers probably wont have that much of an effect but I still think they're a good thing. Its never bad to educate the public...
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    #25
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    Quote Originally Posted by Pickledlemons View Post
    The stickers probably wont have that much of an effect but I still think they're a good thing. Its never bad to educate the public...
    Not sure I entirely agree. I mean it's hard to disagree with educating people, but a little knowledge can be a dangerous thing.

    Only thing worse than an uninformed person is an uninformed person who thinks they're informed.
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