It is no secret at all that we have a major opioid crisis in North America. Was it the fault of Pharmaceutical companies, poorly educated doctors, abuse by some patients or profit hungry drug dealers that created this crisis, does not make much difference today. We have 20-30 percent of our population who suffer from chronic pain and many of them are dependent on opioid medications for their pain control. We have thousands of members of our society who overdose of opioids each year and many of them die. If hundreds of people die for any other health reason it would become a health care crisis and all resources of governments would be directed to manage and prevent that crisis. When it comes to opioid crisis, the issue has many different facets and often the patients suffer from new policies and lack of proper support.
There is a new national guideline for the use of opioids in chronic non-cancer pain in Canada. This guideline is very similar to the latest American CDC guideline on this matter. The recommendations of these guidelines for prescribing opioids reduce the doses of opioids to below equivalent of 90 mg Morphine per day. The logic behind this dose recommendation is that new evidences are now available that these medications in higher doses are more harmful than we knew a few years ago. For example if the technology of a slow releasing medication fails and the pill or patch releases their content faster than it’s supposed duration of action, there is a higher risk of accidental overdose with higher doses compared to lower doses. This creates difficulty for many legitimate chronic pain patients who are functioning and managing their pain with a dose of opioids higher than equivalent of 90 mg Morphine. One of the main challenges of any program that intends to solve dependency problems is Mental Health support. Often patients do not have proper access to any support for the mental and emotional anguish they feel in dealing with their dependency or need for opioid medications.
The idea of good health comes from having a balance in the middle of all of these issues. Opioids when properly used can serve a great purpose of helping the pain enough so that the pain patients can gain better quality of life and better level of functionality. Avoiding higher doses would lead into better level of safety. No pain patient should be exposed to the risk of overdose if it can be avoided.
My hope in making the mypain.ca platform is to support patients who want to bring their opioid doses lower with their wellness needs so they can stand healthier in this difficult journey. I hope any patient who sets foot in this journey would never feel lonely.
Dr. Kevin ROD