The Canadian government is threatening to impose restrictions on doctors who prescribe opioids, and doctors are getting scared.
As a blogger on chronic illnesses, and a fibromyalgia sufferer with a host of other medical issues, I have a bird’s-eye view of the impact of this overblown and misunderstood ‘crisis,’ and the public needs to have a better understanding of what the real issues are.
The visible and hidden crises
The visible crisis
I won’t cite all the numbers of deaths related to opioids, but the largest representation of deaths in Canada from opioid use/overdose comes from illegal opioids. Most notably, Fentanyl, or the illegal market’s version of the drug, has been responsible for 73 percent of “accidental apparent opioid-related deaths” from January to September 2018.
Fentanyl is a drug that is commonly used as an analgesic, and in cases of severe chronic pain, it is sometimes used in patch form or other forms that are carefully prescribed by doctors.
Now, take into account all deaths resulting from the use of heroin and other street drugs, and the picture becomes pretty clear—the big problem stems from the use of illegal street drugs, with a much smaller percentage of opioid overdoses coming from the misuse of prescribed medications.
The hidden crisis
Many doctors and chronic pain clinics reacted to the news of this crisis by restricting or terminating the prescription of opioid-based painkillers for patients, while Doug Ford cut funding in Ontario for nerve blocks (injections to block pain at the nerves for those with chronic pain) from eight nerve blocks every week to two to four nerve blockers only four times a year.
An oxymoron of epic proportions: The government is forcing those patients who have found relief through nerve blocks or prescription pain medication to seek alternative relief. That means that opioid painkillers, which can too easily be bought on the street, become the only option.
Even worse, some patients experience so much pain that they would rather die than live with it, which concerns those doctors who feel that their patients may turn to suicide to end their pain.
One of the members of my chronic pain group is terminally ill with cancer, and with a projected six months to live, her doctor stopped her Fentanyl patches and gave her an experimental painkiller instead. It’s not working, and she doesn’t have time to search around for a doctor who will take her on and put her back on the Fentanyl patch.
Some doctors end up targeting the wrong patients with their blanket policies that aim to reduce the prescription of opioids out of their offices.
Alternative pain relief?
While great strides have been made in cannabis research, its use as a replacement painkiller for opioids is just not up to par.
Fibromyalgia is an excellent condition to use as an example, as opioids simply don’t work for fibromyalgia. As a result, some Fibromyalgia patients turn to either CBD oil (the part of the marijuana plant that does not produce euphoric feelings) or a combination of CBD and THC (the part of the plant that produces the euphoric feelings) to help mediate their pain.
There is some research that shows that for fibromyalgia patients, a 1:1 combination of CBD:THC is helpful, and some specific strains have emerged as being more effective than others, but that’s one condition—and the worst part is, it doesn’t always work.
Marijuana can provide some relief (in combination with opioid medications) for chronic pain patients, but it’s hit-and-miss. CBD oil alone doesn’t work at all for the majority of chronic pain sufferers, despite wild claims about its wonders.
At this point, I need to note that not every street-drug user was a high school kid who fell in with the wrong crowd, started using and got hooked. There are plenty of people who were initially prescribed painkillers for legitimate reasons and became hooked. These patients sometimes look for that ‘fix’ or pain relief elsewhere, which forces them to turn to street drugs.
Shockingly, this situation is often created by the doctors who prescribed the opioids in the first place. Instead of being properly weaned off the opioids, the patients have been cut off cold turkey, which can kill you if you’re addicted.
Imagine you’ve been in a car accident that has left you with severe injuries. You’re immediately put on opioid painkillers, and then maybe you have a few surgeries, which means more opioids.
Eventually, you go home, and you’re still on painkillers. One day, you visit your doctor and you’re informed that you don’t need them anymore; acetaminophen and ibuprofen will do the job. They might—for the pain—but there’s a chance that your brain is addicted to the opioids.
Mindfully taking control
The Canadian government has put into play some solutions that make sense, but cutting back on prescribing opioids for chronic pain and terminally ill patients has created a crisis of its own.
Demand to be weaned off any opioids. Ask about proper treatment for addiction if you find yourself addicted.
Is the government really trying to solve this problem, or are they just throwing spaghetti at the proverbial wall? It’s time to buckle down and do some research on the alternatives to opioids, responsibly wean patients off opioids and examine their role in chronic pain care, instead of exacerbating the problem by cutting off all Canadians on opioids (cold turkey!) and hoping for the best.
If you relate to this cycle of opioid prescription to a cold turkey cut-off, do not blindly accept this! Demand to be weaned off any opioids. Ask about proper treatment for addiction if you find yourself addicted, which may include the use of methadone and other medical treatments.
There is medical assistance for breaking the cycle of addiction, and there are other pain clinics that will listen to you and provide you with the proper medication for your pain.
You have a say in your own care, and you’re your own best advocate!