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Health A to Z  —  9 minutes

Is a simple painkiller responsible for the opioid crisis?

January 12th, 2022
Biron Team
Biron Team

Certain types of pain cause temporary discomfort, while others can last longer and become unbearable. As a result, pharmaceutical laboratories are constantly working to develop new formulas, from ibuprofen to morphine, that are increasingly effective and targeted against pain.

In 1995, a drug was introduced that was advertised as highly powerful without leading to addiction. Since painkillers derived from opiates have the unfortunate property of causing dependency in the long term, this treatment was seen as a major innovation at the time. Backed by a strong marketing campaign, it soon flooded the market. The only problem was that the promise of a non-addictive and harmless product was an outright lie.

OxyContin: trigger for one of North America’s most serious public health crises

Today, it has been proven that OxyContin is a highly addictive painkiller. Public health specialists who have studied this issue believe it is at the root of the fentanyl crisis that has afflicted North America since the early 2000s.

In October 2021, the laboratory Purdue Pharma was ordered in the United States to pay $4.5 billion to the institutions and individuals who were victims of its deceptive practices, because it has now been proven that the Sackler family, the company’s owners, knew about the extreme addiction that its drug caused.[1]

Consequently, the company pleaded guilty before declaring bankruptcy. However, it is estimated that profits from the sale of this drug over a 20-year period would far exceed the amount of punitive damages.

Understanding opioids to get a handle on the crisis

Since antiquity, the poppy plant has been known for its analgesic (pain-relieving) properties. Over the centuries, morphine, a component of opium extracted from the poppy plant, came to be used as a medical treatment especially to control pain.

It is important to note that morphine is the active compound in many substances, such as heroin or codeine. Numerous products have been chemically synthesized to make up the opioid family, also called opiates. This family is divided into three groups: [2]

Weak opioids Opioid substitutes Strong opioids
fFentanyl (and derivatives)

From a simple painkiller to drug addiction

OxyContin, sold by the Purdue Pharma group, is an oxycodone derivative belonging to the strongest class of opioids. As a result, its addictive power is enormous. This has resulted in millions of users becoming hooked on opioids, even though they and their doctors were promised a treatment with no adverse effects.

“OxyContin was at the heart of the opioid tsunami that followed,” says Benedikt Fischer, a researcher at the Centre for Addiction and Mental Health in Toronto. “The demand for illegal opioids was created 10, 15 years ago through the phenomenon of overprescribing in our medical system,” the researcher adds.

It appears that in both the United States and Canada, the authorities and the medical profession have been somewhat complacent on this issue.[3]

Today, even though OxyContin is no longer available and Purdue Pharma has been found liable, the opioid crisis is not over.

Medications don’t work the same way for everyone

Our DNA coding makes each of us unique, but this uniqueness can sometimes make us immune to the effects of certain medications or, conversely, lead to unforeseen side effects.

The ravages of fentanyl

The euphoric effect of OxyContin, along with easy access (despite being a prescription drug), resulted in this analgesic being used recreationally. Due to its powerful addictive properties, some users eventually turned to illegal drugs such as heroin. Then, in the early 2000s, fentanyl appeared on the scene, mainly in British Columbia and our neighbors to the south.

Up to 100 times more potent than morphine, easy to produce as it is synthetic and therefore cheaper than heroin, fentanyl almost entirely replaced OxyContin and heroin on the street. From that point on, the number of overdose-related deaths skyrocketed.[4]

The main hazards of fentanyl

  • A tiny change in dosage can mean the difference between a temporary high and a fatal overdose.
  • Mixing fentanyl with alcohol or other drugs multiplies the risk of death.
  • Various drugs available on the street, in powder and tablet form, may contain fentanyl without the buyer or seller knowing it.[5]

Many overdoses are due to the fact that people were totally unaware their drugs contained fentanyl.

Fentanyl more deadly than COVID-19 in Western Canada

In 2020, more than 1,550 deaths in British Columbia were attributed to fentanyl, versus 900 for COVID-19. In Quebec, the situation was hardly better with 547 victims of fentanyl, according to the Institut national de la santé publique du Québec (INSPQ).

In fact, more than 20,000 overdose deaths were reported in Canada between January 2016 and September 2020. In the United States, the Trump administration even declared a health emergency in 2017 when faced with the magnitude of this crisis.

Dr. Julie Bruneau, a researcher at the Centre de recherche hospitalier de l’Université de Montréal (CRCHUM), believes the pandemic has worsened the situation. Follow-up and research have been more difficult. Redirecting certain services to treat COVID-19 patients, along with social isolation and the housing crisis, have made it even harder for physicians and other professionals to support this marginalized population.

Dr. Bruneau calls it a silent epidemic. She also thinks that if the same number of people between the ages of 20 and 40 had died from COVID-19 rather than an overdose, media coverage of the situation would surely be different. She implies that the lives of drug addicts might not have the same value in the eyes of the authorities and the media as those of ordinary citizens.[6]

Being vigilant in the face of the opioid crisis

Taking painkillers is not without risk, even for basic ibuprofen tablets. It is important to know what is in your pills and to stick to the dosage. You should also avoid self-medication and seek medical advice before using certain treatments.

Here is a list of pharmaceutical products available for controlling pain:

  • Non-opioid medications such as acetaminophen, and non-steroidal anti-inflammatory drugs (NSAIDs), for minor to moderate pain
  • Opioid medications such as codeine for minor pain, and oxycodone or morphine for severe pain
  • Local or topical anesthetics such as lidocaine and EMLA
  • Other medications such as anticonvulsants and antidepressants, which can also help relieve pain[7]

Because some young people are occasionally tempted to experiment, it is also advisable to keep a watchful eye on the most potent substances in your home medicine cabinet.[8]

Lastly, if you have a loved one who is struggling with addiction, Health Canada’s page on the overdose crisis is an excellent source of information. From the stigma associated with drug use to treatments to resources for help, this page covers all areas related to the topic.

Naloxone, the life-saving antidote

Naloxone is a so-called antagonist treatment, capable of temporarily neutralizing the effects of opioids. Naloxone is the best (and so far the only) remedy for fentanyl overdose. It is available free of charge in pharmacies as an injection syringe or nasal spray, and should be included in the emergency kit of people at risk or their loved ones.[9]

For professional support, we are here.

Our pharmacogenetic assessment for pain can help your doctor determine the most appropriate treatment and the best dosage, based on your DNA. Order your kit online or call Biron Health Group customer service at 1-833-590-2713.

  1. J. Michel. “Crise des opiacés aux États-Unis,” La Presse [Montreal], September 1, 2021,
  2. The team at Pharmacomé “Opiacées : les points essentiels,” November 30 2021,
  3. C. Lavigne. “Les dessous de la crise des opiacées,” Radio-Canada, November 8, 2018,
  4. K. Howlett. “Canada’s Opioid Crisis,” The Canadian Encyclopedia, September 17, 2020,
  5. The team at Camh. “Le fentanyl de rue,” 2021,
  6. A. Labrecque. “Surdoses d’opioïdes : crise à l’ombre de la pandémie,” June 3, 2021,
  7. P. Watson and J. Watt-Watson. “Les médicaments contre la douleur,” 2021,
  8. Gouvernement du Québec. “Alcohol consumption, drug use and gambling: helping teenagers,” December 16, 2019,
  9. The team at Pharmacomé “Opiacées : les points essentiels,” November 30, 2021,
Biron Team
Biron Team