Chronic Pain and Drug Abuse

Chronic pain is a daily battle for tens of thousands of Canadians, pain management can come in many forms including strong opioid pain management regimes. There has been a huge amount of media coverage concerning opioid pain medication and its correlation to drug abuse. Over the past fews years the federal government and various provincial governments have taken action to create regulations on how opioids are prescribed to Canadians with moderate or severe chronic pain.

Chronic Pain in Canada

According to the Canadian Pain Coalition chronic pain is pain that has persisted for longer than three to six months, or beyond the natural time of healing, and serves no purpose in the body. This pain can range from mild to excruciating however it does not subside and is constantly present or intermittently persistent.1 This general definition is widely used by various organizations.

The Canadian Pain Coalition reports that 1 in 5 Canadians suffer from chronic pain and that Canadians have tried an average of 2.4 prescribed treatments to alleviate their chronic pain.2 Looking at these statistics it is clear that a large percentage of Canadians suffer from chronic pain and that a good portion would be prescribed opioid based treatments to manage that pain.

The Current Opioid Climate in Canada

Canada is one of the highest consumers of opioids per capita in the world, as steps are being taken to reduce the number of opioids being prescribed in Canada more opioid dependent people are turning to dangerous alternatives to self medicate. Opioid dependence often starts when a person is legally prescribed medication for pain and then as time progresses the person becomes dependent (often unknowingly) because of the highly addictive nature of opioid based painkillers.

“Some people feel better after taking opioids – they’re very effective at relieving acute, short-term pain – and don’t become dependent. But many others who take the drugs are at risk. That’s because the body naturally develops a tolerance to opioids, which means the dose has to be increased in order to experience pain relief. Experts who study opioid drugs say that the higher the dose, the higher the chance of dependence, serious side effects and accidental overdose”3

Long-term treatment of chronic pain that includes an opioid medication regime has been  standard treatment in the past, however changes are taking place in an attempt to curb the increasing opioid dependent population in Canada.

The Center of Addictions and Mental Health states that “Opioid addiction refers to a group of signs or symptoms and behaviours that indicate a person is both physically and psychologically dependent on the substance. Typically the person will continue to use opioids despite the fact that the drug use is causing significant physical, personal or social problems.”4

Rates of opioid abuse in Canada are high and it is not only harming those who use the drugs, it affects coworkers, peers on the road and families, which can include children born to women who may have used the substance during their pregnancy. The National Post indicated that 5.1 per 1000 babies born suffer from neonatal drug withdrawal syndrome in Ontario. This is ratio is nearly double the rates in England and Western Australia (2.7 per 1,000 births) and even higher than the U.S. (3.6).5

These statistics are indicative of a larger societal problem in Canada. Opioid abuse in Canada has hit a level in which many levels of government, including the federal level, have deemed it a health crisis. The crisis has caused dangerous substance like Fentanyl to become a widely used alternative when users can’t access the opioid that they were initially prescribed.

Alternative Treatments for Chronic Pain

Investing in finding alternative treatments for chronic pain would help reduce the number of  prescribed opioid based treatments for those who suffering from chronic pain. As chronic pain is both physical and psychological there are many alternatives that have been shown to assist in managing the problem.

“A growing body of evidence suggests that some complementary approaches, such as acupuncture, hypnosis, massage, spinal manipulation, and yoga, may help to manage some painful conditions.”6

The Ontario Government has decided to  invest 1.3 billion dollars over three years to ensure that those suffering from chronic pain are being given the appropriate treatments for their conditions, with options available other than opioids.7 Working on ensuring that patients are receiving the appropriate treatment for their condition, and not immediately jumping to the ease of simply prescribing an opioid will likely improve the prescription practices.

[1]http://www.canadianpaincoalition.ca/media/cpc_brief_pall_comp_care.pdf
[2]http://www.canadianpaincoalition.ca/media/painful_truth_report.pdf
[3]
[4]https://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/Opioid-Dependence/Pages/default.aspx
[5]http://news.nationalpost.com/news/canada/canadas-opioid-crisis-leading-to-more-babies-born-addicted-study
[6]https://nccih.nih.gov/health/pain/chronic.htm
[7]https://news.ontario.ca/mohltc/en/2014/04/better-care-for-patients-with-chronic-pain.html

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