THE CHRONIC PAIN ASSOCIATION OF CANADA
FOR IMMEDIATE RELEASE Contact: Barry Ulmer
Doctors across Canada are being forced to taper and “discontinue” patients in severe chronic pain from
the medication they need. The result? A return to pain and disability and, in some cases, suicide.
Edmonton, September 6, 2017
At a loss as to how to contain deaths and overdoses in some parts of Canada by addicts who use drugs
illegally, the federal health minister Dr Jane Philpott summoned “experts” to a conference in Ottawa
last November. Sadly, as the Ottawa Citizen wrote, pain specialists and patients weren’t included, and
results were consequently ill-informed. Only two pain patients were invited, and at the last minute one
pain specialist was allowed in, though not to speak. The conference determined that epidemiologists at
McMaster University in Hamilton, Ontario should rewrite Canada’s 2010 opioid prescribing Guideline.
The 2010 Guideline, agreed to by pain specialists and medical groups nation-wide, worked well.
Patients in chronic pain (1 in 5 Canadians) got the medication they needed so long as it relieved their
pain with few side effects. No one has explained why we needed a new one.
The McMaster Guideline was said to be developed in extensive consultation with stakeholders, but
decisions were ultimately appears to be made by a four-person steering committee chaired by Dr Jason
Busse, a chiropractor who can’t prescribe but who is nonetheless an associate professor of
anaesthesiology at the University. The new Guideline slashes medical opioid use by as much as 90% by
advising doctors to taper and “discontinue” otherwise stable and productive patients who’ve enjoyed a
good quality of life—in some cases, for decades. Four patient advisors to the Guideline committee
have withdrawn their names from the final document, which has been loudly derided by many pain
Driving this effort is the myth that street drugs have been diverted from legitimate prescriptions,
despite reports from the Alberta and British Columbia coroners to the contrary, and despite objections
from pain experts. Additionally, the well-respected and representative National Survey on Drug Use
and Health reports that 70% of all opioid misuse starts with medication not prescribed for the misuser.
Moreover, 90% of all addictions—no matter to what—start in adolescents and teens who, for the most
part, are unlikely to be prescribed opioids long-term.
“Discontinued” patients are now contemplating suicide, and some have died. From BC, where the
allowable dose is even lower than in the rest of the country and where doctors can’t prescribe more,
one pain patient told the Roy Green Show that she’d had her lawyer request assisted suicide on her
behalf. The lawyer also told the BC regulatory college that her estate would sue for wrongful death.
Among other evidence, missed or ignored, the new Guideline overlooks a significant 2010 Cochrane
Review of nearly 5,000 patients on opioids long-term, all of whom reported “clinically significant
reductions in pain” with addiction occurring in only 0.27%—a mere 13 patients out of 5,000. Opioids
work for people in pain. Almost none, when properly screened for addiction precursors, gets addicted.
A report just issued in Ontario found that doctors are prescribing fewer opioids to patients in pain.
McMaster’s Dr Busse called the trend “encouraging." Unless, of course, if you’re in pain with your
medication reduced—or gone.
For further information, contact Barry Ulmer: (780) 482-6727
About the Chronic Pain Association of Canada: CPAC is a large network of pain patient support groups
in Canada governed by a volunteer Board of Directors. CPAC is a not-for- profit association whose
goals are to create timely, effective treatment for all those who suffer with pain; to provide support for
those suffering and to improve the area of education and understanding in pain medicine.