ArticleBMJ open2022
How the Suboxone Education Programme presented as a solution to risks in the Canadian opioid crisis: a critical discourse analysis.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Risk management plans and drug safety in Canada: A cross-sectional study.The International journal of risk & safety in medicine · 2026Article
- Reframing the Overdose Crisis: Stigma, Industry Influence, and the Politics of Abuse-Deterrent Opioids.International journal of social determinants of health and health services · 2026Article
- Fentanyl Research: Key to Fighting the Opioid Crisis.Journal of clinical medicine · 2025Article
- Methadone Prescribing Regulation for Opioid Use Disorder in Canada: Evidence for an East-West Policy Divide.Healthcare policy = Politiques de sante · 2024Article
- The Impact of Suboxone's Market Exclusivity on Cost of Opioid Use Disorder Treatment.Applied health economics and health policy · 2023Article
- Pharmaceutical company responses to Canadian opioid advertising restrictions: A framing analysis.PloS one · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPharmaceutical industry involvement in medical education, research and clinical practice can lead to conflicts of interest. Within this context, this study examined how the 'Suboxone Education Programme', developed and delivered by a pharmaceutical company as part of a federally regulated risk management program, was presented as a solution to various kinds of risks relating to opioid use in public documents from medical institutions across Canada.
settingThese documents were issued during the Canadian opioid crisis, a time when the involvement of industry in health policy was being widely questioned given industry's role in driving the overprescribing of opioid analgesics and contributing to population-level harms.
designA critical discourse analysis of 69 documents collected between July 2020 and May 2021 referencing the Suboxone Education Program spanning 13 years (2007-2021) from medical, nursing and pharmacy institutions sourced from every Canadian province and territory. Discursive themes were identified through iterative and duplicate analyses using a semistructured data extraction instrument.
resultsDocuments characterised the Programme as addressing iatrogenic risks from overprescribing opioid analgesics, environmental risks from a toxic street drug supply and pharmacological risks relating to the dominant therapeutic alternative of methadone. The programme was identified as being able to address these risks by providing mechanisms to surveil healthcare professionals and to facilitate the prescribing of Suboxone. Medical institutions legitimised the Suboxone Education Programme by lending their regulatory, epidemiological and professional authority.
conclusionsAddressing risk is considered as a central, moral responsibility of contemporary healthcare services. In this case, moral imperatives to address opioid crisis-related risks overrode other ethical concerns regarding conflicts of interest between industry and public welfare. Failing to address these conflicts potentially imperils efforts of mitigating population health harms by propagating an important driving force of the opioid crisis.
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