Sooke resident Sandra Hughes says pressure on doctors to reduce prescription opioids for patients, or cut them off completely, has left her in constant pain, unable to work and forced to buy dangerous street drugs.
“Percocet, oxycodone, stuff I don’t know the name of, anything to ease the pain,” said Hughes, 51.
“Later today, I kid you not, I will be making inquiries into buying heroin.”
Hughes said there are many others like her, risking their lives to buy illicit street drugs because they cannot cope with the effects of having pain medications rapidly reduced or cut off.
The College of Physicians and Surgeons of B.C. released new guidelines for prescribing opioids in 2016 that more than cuts in half the daily recommended amount of medication. Years of over-prescribing opioids has been cited as a contributing factor to the illicit-drug overdose crisis in the province. In 2016, at least 922 people died from illicit drug overdoses in B.C.
“I spoke with a woman this week whose son got opioids prescribed to a friend’s parents and became addicted,” said Dr. Ailve McNestry, deputy registrar from the college. “It’s well-documented that a lot of teens access prescription medication from friends and family.”
But, Hughes said cutting people off medication increases the risk of more overdoses. “I’ve tried everything to cope with pain. You name it, I’ve tried it: Chiropractor, physio, massage, acupuncture, acupressure, hanging upside-down. Medication is what works,” she said.
Hughes was in a car crash with her mother as a teenager in the early 1980s. Back surgery helped for a few years but doctors warned her the condition would degenerate. “I knew I would end up on pain meds, so I made myself aware of the risks and what to expect,” said Hughes.
She was prescribed up to 300 milligrams a day of slow-release morphine. When the recommended dose guidelines were reduced in 2010, she went to 170 milligrams a day. She said she was in so much pain, she had to quit her job as a teacher’s assistant. A recent switch from a pain specialist to family physician has left her without a prescription since late February.
“I’ve basically become a shut-in,” Hughes said. “I barely recognize myself. I have lost all my friends. Activities that once gave me pleasure are a painful chore, like walking my little dog for 10 minutes.”
Hughes said there are others in similar situations.
Mike, who didn’t want to use his last name, said over the past year his morphine prescription was reduced to 160 milligrams a day from 700.
“Now I’m stuck trying to find something else three days a week or I get really sick,” he said, adding the latter is not an option. He is the primary caregiver for his terminally ill wife.
Mike is a former heroin user who has tried methadone programs. Hepatitis C has left him with severe joint pain, he said.
“I was fine on 300 milligrams a day of the morphine. There’s no harm in that, in that being my life,” he said.
Dr. Owen Williamson, president of the Pain Medicine Physicians Society of B.C., said the new college guidelines are not based on evidence and do more harm than good.
His society is calling for the college to rescind the guidelines and consult with pain specialists and research.
“They developed this policy without consulting pain physicians or scientific evidence,” said Williamson, adding it contravenes the federal health and charter rights by leading to under treatment of pain.
He said it is not appropriate to conflate illicit-drug overdoses with prescription medicine use.
Williamson doesn’t have statistics on how many patients have turned to illicit drugs to compensate for having medications reduced but said anecdotally there are many, and physicians are concerned.
“Part of the problem is you have to provide physicians with the resources and training to deal with these issues. We need a national pain strategy,” he said, pointing out that one in five people are affected by chronic pain.
