‘Opiophobia’ causing pain and suffering in Canada

One in five people suffers from chronic pain and for many opioids gives them a reasonable quality of life

Gwynne Dyer’s column on Jan. 10 points out the impact of the fear of opioid pain medication in the Third World and that millions are dying needlessly in pain from what is called opiophobia. Sadly, this is also happening in Canada and McMaster University can take some credit for this deplorable situation.

I have been writing about this for almost a year now and I’ve appeared on the Roy Green Show on CHML radio, syndicated across Canada, numerous times discussing our War on Pain patients. It is estimated that one in five people suffers from chronic pain and for many of them, the only salvation that gives them a reasonable quality of life are opioids. They are not addicted but they need the pain relief they get from taking opiate medication.

In 2010, pain specialists came up with a set of very reasonable guidelines for doctors to follow when treating patients with chronic pain and those guidelines worked well for everyone. Then, we started getting people who are addicted dying of overdoses from pain pills they were buying illicitly. Often, those pills are laced with fentanyl made in illegal labs in China and Mexico.

Governments panicked and decided that the problem was that too many patients were being prescribed this medication and that was the cause of the problem. Nothing could be farther from the truth. Numerous experts and medial studies have demonstrated that prescribing pain medication does not lead to addiction. The American College of Surgeons issued a press release in 2016 pointing that out.

Overdose deaths among over two million patients prescribed pain meds found that only 0.022% died. Addiction from being prescribed pain meds is estimated to be less than 1 per cent in studies. An August 28, 2017 news report in the Spectator pointed out that opioid deaths in Hamilton are among the highest in Ontario while prescribing opioids for pain is very low.

The former minister of health, Dr. Jane Philpott, commissioned McMaster to come up with a new set of prescribing guidelines which they did. The steering committee who had final say was comprised of a chiropractor/researcher as chair, a specialist in internal medicine/researcher, an anaesthetist and a physician who belongs to a U.S. organization that does not believe that opioids should be prescribed long term for chronic pain.

The recommendations called for a much lower maximum dose than most people use and that doctors start to lower doses for their patients if they are above a certain level.

However, they did divide their recommendations into strong and weak. Weak recommendations were ones where many patients would not agree and would not consider to be appropriate for them. The weak recommendations included lowering doses. This can actually be very dangerous and can lead to death as four pain specialists pointed out in a letter to the Canadian Medical Association Journal this past November.

Doctors are like most of us in that they do not read the fine print and so when they read lower doses for your patients they did that with no regard for the wish of the patient or the outcome. And, they were probably aided in this by the College of Physicians and Surgeons on Ontario who began investigating doctors for their opioid prescribing.

Because of my writing on this topic, people contact me with horror stories. A 76-year-old man in Burlington had his doses cut by over 50 per cent by a doctor who told him he was ordered to do so. This man, a former member of the Canadian military and a retired police officer, has considerable pain as a result.

A woman in Toronto who appeared a number of times on the Roy Green Show and who I wrote about also had her pain medications reduced by over 50 per cent, reducing her quality of life from bearable to horrific. Sadly, she passed away not too long after and, I imagine, in needless pain.

A woman in London, Ontario was fired by her doctor because she needs too many pain pills for a number of serious medical conditions and no doctor will take her on. Her former doctor refused to give her the medical file which legally is hers so she has had to hire a lawyer.

The CBC in Vancouver, Ottawa, and Halifax have all reported that pain patients are now being forced to get their pain medications from street dealers because their doctors have cut them off.

And the reason I blame McMaster is that they have not come out publicly and in strong language to tell doctors that they do not have force their patients to reduce their medications if they are doing well, have no side effects and do not want to. They tell that to the patients I have sent to them with their complaints but that is not good enough.

Addiction is a problem but it is not resolved by attacking those who have nothing to do with it.

Marvin Ross is a Dundas medical writer and publisher

Opioid deaths in Hamilton are among the highest in Ontario while prescribing opioids for pain is very low.