Prescription drug changes proving painful
Editor’s note: This is the first in a two-part series.
Nothing about Bev De Gruchy suggests she’s become an unintentional casualty of the opioid crisis.
Yet the 71-year-old Penticton woman, who considers it a good day when she can move around under her own power, is suffering through the loss of her prescription painkillers and sleeping pills as a result of a new provincial policy inspired by the drug epidemic.
De Gruchy has a host of physical ailments, including Parkinson’s disease, osteoarthritis, and an auto-immune disorder, all of which combine to produce debilitating back pain that can leave her crippled and unable to sleep.
“Sometimes I can’t walk. The pain is so bad I’m almost doubled over,” she says.
To make her more comfortable, doctors began treating her about 20 years ago with codeine, common in Tylenol 3, and morphine. Later, she was prescribed benzodiazepine sedatives like Ativan to help her sleep.
“If I don’t get my sleep, I can’t deal with the pain,” she explained.
That changed in May, however, when her doctor cut her off in order to comply with a 2016 policy change by the College of Physicians and Surgeons of B.C. that bans members from prescribing both opioids and benzodiazepines to the same patient, except for cancer or palliative care.
The college declined an interview request, but according to the policy, which was revised again in June, opioids and sedatives “have high-risk profiles,” and the medical profession has “a collective ethical responsibility to mitigate its contribution to problematic prescription medication use, particularly the over-prescribing of opioids and sedatives.”
“I understand totally the purpose of it – I get it – but you’ve got to take other things into consideration, like the patient,” said De Gruchy, whose doctor asked through her not to be identified or interviewed for this story.
Penticton pharmacist Anthony Rage said he has many clients like De Gruchy who have been impacted by the change.
“I’ve had dozens and dozens of patients in my office crying because they have to choose between their pain medication and their sleeping pills,” he said.
To make matters worse, according to Rage, the new policy is being applied unevenly because the college has audited some doctors, including De Gruchy’s, but not others, who are still prescribing combinations of the two drugs in question.
He described her doctor as “a hell of a nice guy,” who “did everything by the book” by tapering her off, but had to eventually cut the cord under pressure from the college – and went one step beyond by discontinuing both the painkillers and sleeping pills.
Rage believes there should be a system in place to allow policy exemptions for people like De Gruchy who fall through the cracks.
“There are rules for a reason – so you don’t get messed up – but there are sometimes legitimate reasons for particular patients’ needs that have to be addressed,” he said.
“It’s not realistic to expect a rule like this to come down and have everybody adhere to it 100 per cent, because all people are different.”
Rage also believes that medical professionals, including himself, are responsible for the opioid crisis that has claimed thousands of lives. He traces the problem back to the release of OxyContin in 1996, which was accompanied by heavy advertising to doctors.
“And intelligent doctors and pharmacists – all of us – duped into thinking this drug was safe and effective and non-addicting,” said Rage.
Because it was easily abused, OxyContin was taken off the shelf in 2012, leaving some people with no choice but to go to the black market for substitutes like heroin.
“It’s our fault for getting people getting hooked on prescription pain drugs to begin with, and now these people have nowhere to turn but the streets,” said Rage.
Fortunately, there is a relatively new, alternative treatment that holds promise for people like De Gruchy.
Find out more about it tomorrow in Part 2 of this series.