Summary of the Consultation Session at the Opioid Symposium: Further Restricting the Marketing and Advertising of Opioids

Introduction

Prescriptions written by healthcare practitioners are a common way to access opioids in Canada. Health care practitioners receive information from a variety of sources to inform their prescribing decisions and advice to patients, including from the pharmaceutical industry.  Recognizing the urgency of the opioid crisis, and the role that the marketing and advertising of opioids may play in the prescribing of opioids, Health Canada is proposing to further restrict the marketing and advertising of opioids.

Health Canada held a consultation session at the Opioid Symposium on September 5, 2018 to gather feedback from stakeholders on Health Canada’s intention to further restrict marketing and advertising of opioids to health care professionals. This session was in addition to the broader consultation Health Canada launched in June 2018 through a Notice of Intent and subsequent publication of a report summarizing the comments Health Canada received. 

The following summary of the stakeholder consultation session at the Opioid Symposium in Toronto on September 5, 2018 reflects the views of individuals and groups who attended the Opioid Symposium and chose to participate in the consultation session. As such, this summary cannot be accurately generalized to the wider Canadian population and does not necessarily reflect the Government of Canada’s position.

A What We Heard report summarizing the full Opioid Symposium will also be published.

Who provided feedback to Health Canada?

There were close to 200 participants in attendance at the Opioid Symposium, by invitation only. Participants included people with lived and living experience related to opioid use; substance use experts; researchers and academia; law enforcement; first responders; Indigenous groups; drug policy advocates; health care practitioners; health professional organizations; regulatory bodies; health professional education institutions; pain perspective organizations;  and representatives of federal, provincial, territorial, and municipal governments.

In addition, approximately 1600 individuals observing the Opioid Symposium via webcast were invited to submit comments to Health Canada via e-mail.

The session on further restricting the marketing and advertising of opioids was a plenary session open to all participants, including those participating virtually.

What were stakeholders asked?

Following a presentation in which Health Canada provided background on opioid marketing and advertising, participants at the Opioid Symposium were asked to work in small groups to answer the question:

What impact could further restrictions to the marketing and advertising of opioids have on: health professionals; patients with acute or chronic pain; people living with substance use disorder; and others, such as individuals or a group/organization you represent?

What did stakeholders say?

With respect to further marketing and advertising restrictions, participants at the Opioid Symposium provided feedback focused on four key themes:

1. Education for health care professionals and patients is essential to provide accurate and up to date information on opioids.
2. Access to treatment should not be limited for people who need it.
3. Scope of restrictions could extend beyond opioid medications.
4. Stigma could be reduced by engaging individuals living with pain and/or opioid use disorder.

1. Education for health care professionals and patients

Participants highlighted that restrictions on marketing and advertising could limit health care professionals’ access to information about emerging opioid therapies. Participants noted that restrictions could have the consequence of further reducing the information available about opioid use disorder treatments. There was consensus that regardless of the source of the information, there is a strong need for evidence-based information that is up to date on the risks and benefits of opioid products.

Some participants felt that restrictions could increase prescriber awareness of the risks associated with opioids and encourage prescribing decisions based on evidence.

Participants also indicated that restrictions should not limit patients’ access to information regarding opioid treatments. It was suggested that public educational information written in plain language could assist patients and prescribers to safely transition to alternative treatments.

2. Access to treatment

Some participants expressed concern that restrictions on opioid advertising could result in prescribers being reluctant to offer opioid treatments, which would limit patient access to opioids, including for the treatment of opioid use disorder. They highlighted that without access to opioids, individuals may resort to using illegal drugs, increasing the chance of overdose or death.

On the other hand, restrictions on opioid marketing and advertising could lead to greater awareness of non-pharmaceutical treatment options, including physiotherapy, massage therapy, acupuncture, chiropractic care, and cognitive behavioral therapy. Participants noted these treatments may not be widely accessible since they are not covered by provincial and territorial health care plans. Some participants suggested that non-pharmaceutical treatment programs could be funded by governments or a tax on industry for pharmaceutical patents.

3. Scope of Restrictions

Several participants noted that marketing and advertising of prescription drugs is an issue that extends beyond opioids. Others suggested that robust enforcement of existing rules, including the use of criminal sanctions, is necessary.

4. Stigma

Several participants expressed concern that restrictions could further stigmatize individuals living with pain or opioid use disorder, by increasing negative perceptions associated with the use of opioid medications. Some participants noted that decriminalizing illegal drugs could help reduce stigma.

Participants underscored the importance of considering patients’ perspectives when developing policies that aim to reduce problematic opioid use.

Next Steps

We thank all participants who contributed to this consultation session. The feedback received will inform next steps for federal action. We will continue to engage stakeholders and subject matter experts in early 2019.

Visit our Marketing and Advertising of Opioids page for updates on our work and information about other consultation activities.