Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov 2;12(1):45.
doi: 10.1186/s13011-017-0130-5.

The opioid crisis: past, present and future policy climate in Ontario, Canada

Kristen A Morin  1 , Joseph K Eibl  2 , Alexandra M Franklyn  2 , David C Marsh  3   4
Affiliations

The opioid crisis: past, present and future policy climate in Ontario, Canada

Kristen A Morin et al. Subst Abuse Treat Prev Policy. .

Abstract

Background: Addressing opioid use disorder has become a priority in Ontario, Canada, because of its high economic, social and health burden. There continues to be stigma and criticism relating to opioid use disorder and treatment options. The result has been unsystematic, partial, reactive policies and programs developed based on divergent points of view. The aim of this manuscript is to describe how past and present understandings, narratives, ideologies and discourse of opioid use, have impacted policies over the course of the growing opioid crisis.

Commentary: Assessing the impact of policy is complex. It involves consideration of conceptual issues of what impacts policy change. In this manuscript we argue that the development of polices and initiatives regarding opioids, opioid use disorder and opioid agonist treatment in the last decade, have been more strongly associated with the evolution of ideas, narratives and discourses rather than research relating to opioids. We formulate our argument using a framework by Sumner, Crichton, Theobald, Zulu, and Parkhurs. We use examples from the Canadian context to outline our argument such as: the anti- drug legislation from the Canadian Federal Conservative government in 2007; the removal of OxyContin™ from the drug formulary in 2012; the rapid expansion of opioid agonist treatment beginning in the early 2000s, the unilateral decision made regarding fee cuts for physicians providing opioid agonist treatment in 2015; and the most recent implementation of a narcotics monitoring system, which are all closely linked with the shifts in public opinion and discourse at the time of which these policies and programs are implemented.

Conclusion: We conclude with recommendations to consider a multifactorial response using evidence and stakeholder engagement to address the opioid crisis, rather than a reactive policy approach. We suggest that researchers have an important role in shaping future policy by reframing ideas through knowledge translation, formation of values, creation of new knowledge and adding to the quality of public discourse and debate.

Keywords: Coordinated care; Health policy; Ideology; Opioid agonist therapy; Opioids; Substance use disorders.

PubMed Disclaimer

Conflict of interest statement

Authors’ information

KA Morin is a PhD candidate with the School of Rural and Northern Health at Laurentian University who has experience working in health policy and funding in Ontario. JK Eibl is a post-doctoral fellow and an astute scholar with the Northern Ontario School of Medicine. AM Franklyn is an MD candidate at the Northern Ontario school of medicine. DC Marsh maintains the following roles: Chief Medical Canadian Addiction Treatment Center, opioid agonist therapy provider, and Associate Dean of Community Engagement and Deputy Dean of the Northern Ontario School of Medicine. He is a well-established physician and researcher in the addiction medicine field.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Universities have no ability to prevent publication and dissemination of knowledge.

Competing interests

DC Marsh has no ownership stake in the CATC as a stipendiary employee. We do not foresee any conflict of interest. The authors have no conflicts to declare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
An analytical framework for factors shaping research impact on policy (Sumner, Crichton, Theobald, Zulu, Parkhurst, 2011)
See this image and copyright information in PMC

References

    1. Dhalla IA, Mamdani MM, Sivilotti ML, Kopp A, Qureshi O, Juurlink DN. Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone. CMAJ. 2009;181:891–896. doi: 10.1503/cmaj.090784. - DOI - PMC - PubMed
    1. Kiepek N, Groom B, Toppozini D, Kakekagumick K, Muileboom J, Kelly L. Evaluation of an inpatient medical withdrawal program in rural Ontario: a 1-year prospective study. Can J Rural Med. 2015;20:92–97. - PubMed
    1. Lynas K. Ontario pharmacists concerned about the risks arising from approval of generic OxyContin. Can Pharm J (Ott) 2013;146:12–13. doi: 10.1177/1715163512473928. - DOI - PMC - PubMed
    1. Lynas K. Ontario police chiefs call on the federal government to keep generic OxyContin out of Canad. Canadian Pharmacist Journal. 2013;45 - PMC - PubMed
    1. Standing committee on health. Office of the Speaker of the house of commons. Ottawa: Government of Canada; 2016.

Publication types

Grants and funding