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

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...

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Autores principales: Morin, Kristen A., Eibl, Joseph K., Franklyn, Alexandra M., Marsh, David C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667516/
https://www.ncbi.nlm.nih.gov/pubmed/29096653
http://dx.doi.org/10.1186/s13011-017-0130-5
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author Morin, Kristen A.
Eibl, Joseph K.
Franklyn, Alexandra M.
Marsh, David C.
author_facet Morin, Kristen A.
Eibl, Joseph K.
Franklyn, Alexandra M.
Marsh, David C.
author_sort Morin, Kristen A.
collection PubMed
description 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.
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spelling pubmed-56675162017-11-08 The opioid crisis: past, present and future policy climate in Ontario, Canada Morin, Kristen A. Eibl, Joseph K. Franklyn, Alexandra M. Marsh, David C. Subst Abuse Treat Prev Policy Commentary 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. BioMed Central 2017-11-02 /pmc/articles/PMC5667516/ /pubmed/29096653 http://dx.doi.org/10.1186/s13011-017-0130-5 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Commentary
Morin, Kristen A.
Eibl, Joseph K.
Franklyn, Alexandra M.
Marsh, David C.
The opioid crisis: past, present and future policy climate in Ontario, Canada
title The opioid crisis: past, present and future policy climate in Ontario, Canada
title_full The opioid crisis: past, present and future policy climate in Ontario, Canada
title_fullStr The opioid crisis: past, present and future policy climate in Ontario, Canada
title_full_unstemmed The opioid crisis: past, present and future policy climate in Ontario, Canada
title_short The opioid crisis: past, present and future policy climate in Ontario, Canada
title_sort opioid crisis: past, present and future policy climate in ontario, canada
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667516/
https://www.ncbi.nlm.nih.gov/pubmed/29096653
http://dx.doi.org/10.1186/s13011-017-0130-5
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