New opioid prescription policies released last week reflect what Kelowna害羞草研究所檚 Brian Gervais has been saying.
Some of the responsibility for B.C.害羞草研究所檚 drug crisis rests on how doctors doled out medication in the last decade.
害羞草研究所淚害羞草研究所檝e been watching the (opioid crisis) happen from a first-hand perspective, and it害羞草研究所檚 been very frustrating,害羞草研究所� said Gervais. 害羞草研究所淒octors were handing (opioids) out like candy.害羞草研究所�
Gervais has Crohn害羞草研究所檚 disease and five years ago a complication from his condition led to a painful intestinal surgery. Complications from that initial operation then led to three more surgeries, and what he describes as an incredibly painful recovery.
To manage the pain, he was prescribed Hydromorphone, which is also known as dihydromorphinone, and sold under the brand name Dilaudid, among others. It害羞草研究所檚 a centrally acting pain medication of the opioid class and a derivative of morphine.
害羞草研究所淲hen you take it, you aren害羞草研究所檛 told you are taking something equivalent to heroin害羞草研究所攖hey just don害羞草研究所檛 tell you about that,害羞草研究所� he said.
Gervais said he was prescribed the medication because he was unable to work, and therefore on a fixed income. That meant he couldn害羞草研究所檛 afford any other style of treatment that would have helped reduce the symptoms of chronic pain.
害羞草研究所淚f you害羞草研究所檙e a person on disability making $900 a month, the only thing you could do to manage your pain was take the drugs provided by the government,害羞草研究所� he said. 害羞草研究所淭hey didn害羞草研究所檛 pay for physiotherapy or massage and (the drugs) are quick acting.害羞草研究所�
What Gervais didn害羞草研究所檛 realize when he first was prescribed those pain meds, however, is that he was going to become an addict in addition to being chronically ill and chronically in pain.
害羞草研究所淚 was taken on a ride and thinking, 害羞草研究所榯his is what I was supposed to do,害羞草研究所櫤π卟菅芯克鶟 he said.
害羞草研究所淏ut when you take opioids you are building a tolerance. It doesn害羞草研究所檛 matter how strong-willed you are, your body reacts as it does and tolerance keeps building and growing.害羞草研究所�
It害羞草研究所檚 no secret that Canada is now in the midst of an opioid epidemic.
This country is the world害羞草研究所檚 second highest per-capita consumer of opioid pain relievers. In an article spelling out new prescribing policies, the Canadian Medical Association Journal said in Ontario admissions to publicly funded treatment programs for opioid-related problems doubled from 2004 to 2013, from 8,799 to 18,232.
害羞草研究所淎mong Ontarians receiving social assistance, one of every 550 patients who started on chronic opioid therapy died of opioid-related causes at a median of 2.6 years from the first opioid prescription, while one in 32 of those receiving 200 mg morphine equivalents daily or more died of opioid-related causes.害羞草研究所�
In B.C. the links to prescriptions haven害羞草研究所檛 been made as clear, but the overdose crisis prompted the health minister to call a state of emergency in 2016 and overdose deaths have yet to slow down in 2017.
With no choice but to recognize the problem, the 2017 Canadian Guideline for Opioid Therapy and Chronic Noncancer Pain was released May 8, calling on doctors who treat people with chronic pain to restrict the prescribing of opioid drugs like Percocet, OxyContin, Dilaudid and morphine.
Their first line of action is now to be prescribing non-drug treatments and non-opioid drugs before turning to a prescription for opioids. They say that opioids should only be prescribed after other treatments are tried and only after other treatments are given a fair trial.
Doctors are also dissuaded from prescribing opioids to patients with a prior history of alcohol or drug abuse or active mental health disorder.
The recommendations also address the escalating needs of opioid users, establishing a maximum dose of 50 to 90 mg a day.
Gervais said some of these methods may have helped when he was initially dealing with pain, but he害羞草研究所檚 concerned about what happens to those who have already developed an addiction being put on a prescription cap.
Increasing tolerance requires an ever-increasing dose of drugs and once tolerance has been built, that害羞草研究所檚 when things get complicated.
害羞草研究所淲hen government initially decided they wanted to get everyone off of it, people started struggling to find doctors to help,害羞草研究所� he said, of a mandate that predated the new round of recommendations.
害羞草研究所淚 was told I害羞草研究所檇 just have to deal with it and find other ways to deal with the pain. I wasn害羞草研究所檛 given an answer on what that would be.害羞草研究所�
The sudden change in tack caused many to go to the streets to meet their needs.
Gervais wasn害羞草研究所檛 much better off. The doctor who had long treated him cut him off, but he said he was lucky to find another who picked up the prescription to ensure that Gervais would have safe access to medication.
Then he took another course of action.
To address what害羞草研究所檚 become a well-established addiction, Gervais decided to do a quick detox and then get prescribed Suboxone, a drug that blocks the effects of opioids.
害羞草研究所淭his new program in Victoria called the rapid detox opiate withdrawal is a brutal program but it gets you off quick and gets you going back to your life,害羞草研究所� said Gervais.
害羞草研究所淚 want to just strongly, strongly say that if you are going to have surgery or if you have pain in any way and you have an option to start on opiates or not害羞草研究所攄on害羞草研究所檛. Trust me when I say the physical pain you will be masking is nothing in comparison to the life and years you will lose from starting on that medication.害羞草研究所�
Being on Suboxone, he said, isn害羞草研究所檛 exactly freedom, but it害羞草研究所檚 a step in the right direction and a step he hopes more opioid addicts take, while more of the community learn about what害羞草研究所檚 created the issues at hand.
害羞草研究所淚t makes me so angry,害羞草研究所� he said. 害羞草研究所淚 see a lot of people being blamed for being addicts who really didn害羞草研究所檛 understand what they were getting into to begin with.害羞草研究所�
