According to a story from the Vancouver Sun, the College of Physicians and Surgeons of B.C. recently issued new requirements in regards to the usage of opioids for treating patients with chronic pain. These new rules get rid of a previous limitation on dosing. Earlier national guidelines recommended that patients be limited to a dosing equivalent of 90mg of morphine a day for all opioids; now, doctors will be expected to work with patients to determine an appropriate dosage level. In addition, doctors will no longer be allowed to refuse to see patients that have previously used or are currently taking opioids.
The old standard
The old standard was primarily the result of a public health emergency declaration in April of 2016. The emergency was issued after a severe uptick in overdose deaths from the highly addictive painkillers, primarily from fentanyl, an extremely potent opioid that has found popularity as a street drug. As of this article, B.C. still has the highest rate of opioid overdose deaths in Canada.
Unmet patient needs
The newest rules were issued after many patient advocacy groups complained that doctors were denying proper care to patients that were using opioids. This discrimination is probably due to caregivers fearing that they will be responsible for getting patients addicted and causing an overdose. However, most of the overdoses in the province were linked to illicitly obtained street drugs, not prescription medication.
Regardless, discrimination in healthcare for any reason is unacceptable. An example is the case of Andrew Koster, who has ankylosing spondylitis. This is a form of arthritis that causes inflammation to the joints of the spine. The most pervasive symptom is chronic pain in the lower back. This pain can have a major impact on quality of life, and for Andrew, opioids were the only source of relief. To learn more about ankylosing spondylitis, click here.
According to Andrew, the emergency declaration made his doctor ignore his attempts to switch to a more powerful opioid drug to treat his pain; the one he had been using for the past eight years was no longer helping him.
In addition, he feared that he would be forced off of opioids, and felt stigmatized for using them. He recalls episodes of being thrown out of the ER while his back was in pain, accused of seeking the drugs.
Thankfully, his current doctor has helped him taper off of opioids, and he takes only half of the dose that he used to. Hopefully, these new rules will help patients find the relief they need without worsening the crisis.
