Chronic pain sufferers are stigmatized by backlash
Backlash from media coverage of the opioid epidemic is putting the health of chronic pain patients at risk.
A survey of more than 1,400 patients from Quebec and British Columbia made public Wednesday suggests that the extensive media coverage of the opioid crisis has had a significant negative effect on those suffering from chronic pain.
The survey showed some doctors have became reluctant to prescribe narcotics for pain relief. Patients reported having trouble getting the medication they need to control their pain and that doctors are reducing their doses against their wishes. Also, pharmacies won’t issue their prescriptions, and their insurance companies have refused to refund their prescriptions in the last 12 months.
The fentanyl-laced drugs driving the opioid crisis in North America have led to negative images of legitimate patients, who use medication to control their pain, as addicts, said study co-author Jean-Luc Kaboré, PhD student in the department of pharmacology at Université de Montréal.
“Patients are stigmatized twice,” Kaboré said. “First, because they suffer from pain. And second, by the problem of getting treatment.”
Kaboré is part of the study team led by Manon Choinière at the Centre hospitalier du l’Université de Montréal research centre, in collaboration with researchers from McGill, Laval and Sherbrooke Universities.
The survey found that 11 per cent of patients in both provinces who were deprived of their prescription opioids in the last 12 months turned to the street and internet, or sought the help of another doctor, or friends and family to get drugs for pain relief.
This is a serious issue because more than 20 per cent of adult Canadians have non-cancer pain, defined as a painful condition that persists for more than three months and interferes with daily living, said Choinière, who reported the study’s results Wednesday at the annual meeting of the Quebec Association for Chronic Pain (AQDC).
Prescriptions more than doubled in the United States between 1992 and 2010, and Canada followed suit, as the second-largest per capita consumer of opioids in the world, while simultaneously abuse, addiction and black market sales jumped. Opioid overdose deaths escalated, mostly from illicit heroin and fentanyl-laced drugs. To address this crisis that was widely reported in the media, U.S. and Canada tightened their guidelines on opioid prescriptions.
Conducted online between January and April 2018, survey questions included patients’ opinions, concerns and difficulties accessing opioid treatment. Participants in both provinces said media coverage worsened the image of chronic pain sufferers who take prescription drugs to relieve their pain. However, when it came to other comparisons, the survey noted a greater impact on patients in B.C., Choinière said.
For example, about one in four B.C. pain patients, or 26 per cent, say their doctor asked them to stop taking narcotics. That’s twice as many as their counterparts in Quebec, where 14 per cent of patients were asked to discontinue their pain medication.
Compared with Quebec, four times as many patients in B.C. had their medication discontinued.
“Of those who had their opioid prescriptions discontinued in the past 12 months, 19 per cent of the B.C. patients disagreed with the interruption compared with only five per cent in Quebec,” Choinière said, adding that these differences are statistically significant.
The percentage of patients who had not used opioids in the last year was significantly higher in Quebec (37 per cent) than in British Columbia (25 per cent).
In Quebec, the fear of becoming addicted is greater than in B.C.: 20 per cent of participants said they worry that opioid use will turn them into addicts compared with only seven per cent in B.C.
Also, 15 per cent of Quebec participants said it was impossible for them to find a family doctor to treat their pain, she said.