Prince Edward Island’s plans to further restrict legal prescriptions of pain killers will harm the long-term disabled and terminally ill.
PEI Health Minister Doug Currie promoting new regulations that will harm people with disabilities
The new legislation will limit legal prescriptions for those suffering chronic pain in the terminal stages of life.
Using data from PEI’s maligned health information system, PEI’s Minister of Health plans to limit pain medication for PEI’s 25,000 disabled.
Narcotic pain killers are already highly regulated in Canada and access for people with chronic pain and disabilities can be difficult. New regulations are a likely a smokescreen of other changes in the PEI healthcare system.
People without disabilities should to walk a mile in the shoes of those with disabilities for whom severe pain is a constant companion before sounding the clarion bell of “drug abuse.” The Minister of Health is embarking on a new “war on drugs” PEI-style.
The new legislation is not based on science but on misinterpretation of flawed data from the government’s new Health Information System. The computer report is not reliable on its face. The real data shows a slight increase in oxycodone and Percocet not any alarm rise in use.
Health PEI reports do not show a marked increase in narcotics other than OxyContin, the trade name for Oxycodone, and Percocet (chart NJN Network from Health PEI data)
The government should be drilling down to study outcomes from prescription drug use and then the specific problem drugs like oxycodone, which is dangerous, not morphine and T3s.
PEI’s mainstream media re-printed the government press releases without researching the topic. “Prescriptions for these five drugs have been rising steadily over the last five years. They grew by an average of 17 per cent between 2009 and 2012.” (Guardian)
Impact of narcotics regulations and fines
Government regulations will instill more fear and punishment with doctors and pharmacists. These regulations are not going to help those with severe pain who need relief.
It will mean fewer doctors are willing to risk fines and penalties threatened by the new legislation, making PEI’s already acute medical access problem worse for 25,000 people living with disabilities on PEI. It’s a solution chasing the wrong problem.
10,000 people on PEI don’t have a family doctor. (CBC). They go to clinics that will not prescribe narcotic painkillers. When their medication runs out or they need a change, Islanders with disabilities are sent to the Emergency Department for relief.
Even with a family physician, it is easy to run out of medication during severe bouts of pain. The pharmacists are already constrained on the amount and timing of prescription renewals. People with disabilities are left without legal recourse to needed relief from pain. Street level drug dealers like the situation and will no doubt be the only beneficiaries of the new rules.
A person with a disability on long-term pain medication cannot risk leaving their home city or town near the monthly renewal date if they run out and can’t get a refill. For someone with severe chronic pain, this is a real issue.
Why opiate pain killers?
“Opiates have been used for centuries and remain to this day the most potent and reliable analgesic agents (Pasternak, 2011). US National Library of Medicine.
Opium based narcotics are not evil drugs, although some of them are highly addictive and use is restricted and monitored by health practitioners. They are derived from the opium poppy and are the most effective relief for pain.
People living with disabilities often suffer from acute severe pain. Along with rest, proper exercise, meditation, acupuncture, marijuana and other pain treatments, narcotics give pain relief. Today’s world does not allow people with disabilities to simply leave meetings, drop out, meditate in place or use anything more than pop a pill and keep working.
For people with long-term disabilities, Tylenol 3 (T3’s) is a relatively safe pain reliever. T3 is less likely to be addictive and the risks are from the overuse of acetaminophen and alcoholism. Use of Tylenol 3 or T3’s is actually going down on PEI but the government plans to restrict them by lumping them in with the dangerous oxycodone and Percocet. (see above chart)
For more severe pain, Dilaudid or Hydromorphone are used in a clinical setting. Morphine, the most addictive natural narcotic, is used for severe pain in terminal cases or for conditions like kidney stones where medication is temporary. Both Dilaudid and morphine are administered under strict control of physicians.
What controls beyond Federal drug regulations on doctor administered pain killers can the PEI government wisely propose? Is the government substituting politics for medical science and experience?
Dangerous narcotics
Synthetic narcotics were such as Ocycondone and Percocet were promoted as safer replacements for natural opiates. However, new research shows them to be both highly addictive and lethal. See Oxycodone is a disaster waiting to happen
Politics or sound public policy
On April 16th, the Honorable Doug Currie Minister of Health announced in the Legislature “I will be bringing some very aggressive legislation in before the sitting is over to look at tighter controls around narcotic scripts”
Prince Edward Island has some of the lowest use of narcotic pain killers in Canada. The amount of heroin or narcotic based pain-killer abuse on PEI is statistically insignificant.
That reflects a national trend of declining use of narcotics by Canadians since 2008. In 2011, use of pain killers in Canada dropped to 17% of the population, from 22%. Abuse of pain killers has dropped from about 3% to below 1% and is statistically unreliable. (Canadian Alcohol and Drug Use Monitoring Survey)
We wrote the Minister and asked for his comments. We will print them tomorrow.
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