Opioids can be a safe and effective treatment for pain, shows study

CANADIAN PAIN SOCIETYDec 8 2009

A response to the study on opioid analgesic related deaths in Ontario published in the Canadian Medical Association Journal

A study published in the current issue of the Canadian Medical Association Journal (CMAJ) by Dhalla et al. has reviewed opioid-related deaths in Ontario from 1991 to 2004. The Canadian Pain Society (CPS) is very concerned that a small percentage of the population is misusing opioid analgesics, also called narcotic pain killers, resulting in harm and even death. Opioids can be a very safe and effective treatment for pain when used for the right reason by the right person. Any measures put into place to reduce the misuse of prescription opioids should not penalize the vast majority of people with pain who use these medications appropriately.

"The solutions for this important societal problem are complex," said Dr. Mary Lynch, President of the Canadian Pain Society. "We require better quality of care and adequate resources to provide alternative, best-practice pain management programs for all Canadians who suffer from needless pain."

In chronic pain, opioids work best when combined with a structured interdisciplinary, biopsychosocial treatment program," said Dr. Pat Morley-Forester, Director University of Western Ontario Interdisciplinary Pain Program. "It is unfortunate that in Ontario, the largest province in the country, there is not a single, publically funded, accessible, interdisciplinary pain management program. The one existing full service program serves only third-party funded patients creating a system of two-tiered pain treatment. Other pain management programs rely on a patchwork of funding sources that does not allow for best practice interdisciplinary care. Other provinces such as Alberta, Nova Scotia and Quebec have better public access to these programs."

Up to one in four people who visit the emergency department complaining of pain, have chronic pain as a presenting problem. (Todd 2007) A survey conducted in 2007 and 2008 of more than 4,000 Canadians found that an estimated one in six Canadians - six million people - suffer from chronic pain (Nanos 2007-2008). Estimates place direct health care costs for Canada to be more than $6 billion per year for individuals suffering from chronic pain. By 2025, with the aging population, these costs can be expected to rise to more than $10 billion per year (Phillips & Schopflocher, 2008) Among those with moderate to severe chronic pain, almost 60 per cent had lost their job, suffered loss of income or had a reduction in job responsibilities as a result of their pain, costing the economy billions of dollars annually in lost workplace productivity.

People living with chronic pain deserve access to best practice pain management - including the proper use of opioid analgesics when indicated.