MISGUIDED STRATEGY TO DEAL WITH OPIOID OVERDOSES TARGETS LEGITIMATE PATIENTS IN CHRONIC PAIN
September 5th, 2017
THE CHRONIC PAIN ASSOCIATION OF CANADA
FOR IMMEDIATE RELEASE Contact: Barry Ulmer
Misguided Strategy to Deal with Opioid Overdoses Targets Legitimate Patients in Chronic Pain
Doctors across Canada are being forced to taper and "discontinue" patients in severe chronic pain from the medication they need. The result? A return to pain and disability and, in some cases, suicide.
Edmonton, September 5, 2017
At a loss as to how to deal with the increasing overdose deaths across Canada by addicts who use drugs ilegally, the then federal Health Minister, Dr. Jane Philpott summoned "experts" to a conference in Ottawa last November. Sadly, as the Ottawa Citizen wrote, pain specialists and patients were not included in any of the presentations, and results were consequently ill-informed. Only two pain patients were invited, and at the last minute one pain specialist was allowed in, though not to speak. The conference determined that epidemiologists at McMaster University in Hamilton, Ontario should rewrite Canada's 2010 opioid prescribing Guideline.
The 2010 Guideline, agreed to by specialists and medical organizations across Canada, worked well. Patients in chronic pain (1 in 5 Canadians) were able to get needed relief and medication as required as long as it improved their pain, quality of life and had few side effects. No one has explained why we needed a new one.
The McMaster Guideline was said to be developed in extensive consultation with stakeholders, but it appears decisions were ultimately made by a four-person steering committee chaired by Dr. Jason Busse, a chiropractor who can't prescribe, but who is nonetheless an associate professor of anaesthesiology at the University. The new Guideline slashes medical opioid use by as much as 90% by advising doctors to taper and "discontinue" medication to otherwise stable and productive patients who've enjoyed some quality of life--in many cases, for decades. Several patient advisors to the Guideline committee have withdrawn their names from the final document, which has been loudly derided by many well respected pain specialists.
Driving this effort is the myth that street drugs have been diverted from legitimate prescriptions, despite reports from the Alberta and British Columbia coroners to the contrary, and despite objections from pain experts. Additionally, the well-respected and representaive National Survey on Drug Use and Health reports that 70% of all opioid misuse starts with medication not prescribed for the misuser. Moreover, 90% of all addictions--no matter to what--start in adolescents and teens who, for the most part, are unlikely to be prescribed opioids long-term.
"Dismissed" or "tapered" patients are now contemplating suicide, and some have died. In B.C., where the allowable dose is even lower than the rest of the country and where doctors are prevented from prescribing more, one patient told the Roy Green Show that she had her lawyer request assisted suicide on her behalf. The lawyer also told the B.C. regulatory college her estate would sue for wrongful death.
Among other evidence it's missed or ignored, the new Guideline overlooks a significant 2010 Cochrane Review of nearly 5,000 patients on opioids long-term, all of whom reported "clinically significant reductions in pain," with addiction occuring in only 0.27%--a mere 13 patients out of 5,000. Opioids work for people in pain. Almost none, when properly screened for addiction precursors, get addicted.
A report, just issued in Ontario, found that doctors are prescribing fewer opioids to patients in pain. McMaster's Dr. Busse called the trend "encouraging." Unless, of course, if you're in pain with your medication reduced--or even worse gone.
For further information, contact Barry Ulmer: (780) 482-6727.
About The Chronic Pain Association of Canada: CPAC is a large network of pain patient support groups in Canada governed by a volunteer Board of Director. CPAC is a not-for-profit association whose goals are to, when possible, create timely, effective treatment for all those who suffer with pain; to provide support when possible for those suffering and to improve the area of education and understanding in pain medicine.