Treating Chronic Pain Does Not Always Mean Using Opioids

July 06, 2017, Kitchener, Ontario

Posted by: Robert Deutschmann, Personal Injury Lawyer

Primary care doctors have been using opioids to manage acute and chronic pain for centuries. Acute pain is short term intense pain (post surgical, post accident) and is effectively managed with many medications including opioids.  The course of drug use is short and limited, and for many people higher doses of Ibuprofen are now being used in place of opioids which may be given immediately post surgically.

However, chronic pain is a terrible thing. It grinds you down slowly, depriving you of sleep, leaving you in constant pain, sometimes severe. It can leave you irritable, forgetful and eventually it can interfere with your day to day relationships, and work. Chronic pain can result form the aftermath of surgeries or accidents (think of wounds that never heal correctly, parts of the body that are irreparably damaged, mechanical back pain). Until very recently many people suffering chronic pain have been steered to quickly to opioids. For some, it remains the medically correct option, for others there are much better solutions.

Long term opioid use carries serious side effects including addiction, but also foggy minds, lethargy and stomach problems. Recent studies at Harvard have shown that the rate of opioid prescription for chronic pain management in the USA is alarming. The trends are similar in Canada with the Public Health Agency of Canada reporting that there were 2458 apparent opioid related deaths in Canada in 2016. Western Canada had the highest rates of death (1/10000 people) in Canada, with the country as a whole having a rate of 0.8/10000 people.

With the alarming news about addiction rates of prescribed users, and the addiction rates of addicts misusing opioids healthcare professionals are taking a new look at alternative treatments for some people with chronic pain. The reasons for high rates of prescription of opioids are many.

• They are cheap and effective for use as a first-line treatment.
• Most Canadians do not have coverage for non-pharmacological health services (physio, chiropractic etc)
• Lack of other options available

The treatment of many chronic conditions such as back pain, is complex and requires a multipronged approach. This is often a problem for those with no access to rehab therapy, massage, acupuncture, mindfulness and exercise. In many parts of the country the services are not easily accessible (if they even exist) or are too expensive.

The government of Ontario has funded a new initiative called the Spine Assessment and Education Clinics. They are primary physician led and see a group of therapists working together with the patient. The patient I referred by the family doctor and get assessed by advanced care physiotherapists and chiropractors. A care plan is developed and funded by the province. The system is promising, and may be a model for all people who suffer from chronic pain.

If you suffer from chronic pain you should speak to your doctor about your treatment plan. If this is a lifelong condition you’ll have to consider treatment options that will work over years or decades. You should ask your doctor about:

• Conservative therapies like message and physio
• What kind of exercise will improve your condition?
• Will weight loss help?
• Are the drugs you are taking now opioids?
• Are there options to the opioids that may be as effective?

https://www.canada.ca/en/health-canada/services/substance-abuse/prescription-drug-abuse/opioids/national-report-apparent-opioid-related-deaths.html

About Deutschmann Law

Deutschmann Law serves South-Western Ontario with offices in Kitchener-Waterloo, Cambridge, Woodstock, Brantford, Stratford and Ayr. The law practice of Robert Deutschmann focuses almost exclusively in personal injury and disability insurance matters. For more information, please visit www.deutschmannlaw.com or call us at 1-519-742-7774.