Patient Advocates Critical of Canadian Pain Task Force Report

By Pat Anson, PNN Editor

A new report from the Canadian Pain Task Force is being called “political propaganda” and “shameful” by patient advocates.

The 75-page report was released last week by the task force, an advisory panel created by Health Canada in 2018 to help it address the needs of nearly 8 million Canadians who live with chronic pain. Like many of their counterparts in the United States, Canadian pain patients often have trouble getting access to opioid medication because of fears the drugs will lead to misuse and addiction.

The task force said it released its second report “with a sense of urgency” because the COVID-19 pandemic had reduced access to healthcare and social services for many people. The report calls chronic pain a “legitimate disease” and said better efforts were needed to provide access to pain treatment, improve public awareness and reduce stigma associated with chronic pain.

“Recent dramatic increases in opioid-related overdose deaths in North America have heightened awareness around the risks associated with both short- and long-term opioid use for chronic pain. However, efforts undertaken to respond to the overdose crisis have led to challenging unintended consequences for people living with chronic pain,” the report found.

“Some people in Canada have been unable to access opioid medications, and others who previously relied on opioids to manage their pain have been unable to continue their medications, or have had significant adjustments to lower their prescriptions, sometimes against their will.”

The task force also released findings from surveys and interviews with nearly 2,000 Canadians – both patients and providers -- who often had “differing expectations” about how chronic pain should be treated. Patients complained of limited access to specialists, long wait times, and treatments that didn’t work or were harmful.

“Many people living with chronic pain have experienced trauma in the context of medical care. They may have had invasive investigations and procedures or negative interactions with health professionals. Such experiences can be damaging on their own, but when compounded with previous trauma can lead to more drastic challenges such as changes in sense of self, view of the world, and nervous system dysregulation, which may all contribute to increased pain and difficulties coping,” the report found.

‘Nothing New’

But outside of announcing $3.5 million in funding for three local health projects, no immediate steps were announced by Health Canada or its task force to improve pain care for Canadians. The panel is not expected to release its third and final report until December 2021.

“There is nothing new in this report,” said Barry Ulmer, Executive Director of the Chronic Pain Association of Canada, a patient advocacy group. “Have they forgotten this is a 3-year study, which will not be completed until 2021? In the meantime, while they fiddle, Canadians continue to suffer and die when the solutions are already there, yet we continue to spend over $3 million taxpayer dollars. So where is the sense of urgency?”

The task force outlined its “next steps” with a vaguely worded statement that “leadership and resources are needed to amplify, spread, and accelerate current activities, coordinate responses, address current gaps and inequities, and reduce the variability across jurisdictions.”    

“This is simply a carefully constructed document to create the appearance of having listened to patient input, and to suppress the substance of changes demanded by both patients and doctors. It is political propaganda of the worst sort,” said Richard Lawhern, PhD, a patient advocate and co-founder of the Alliance for the Treatment of Intractable Pain (ATIP).

“Contrary to the biased declarations of this report, there is no evidence that increased availability of prescription opioids in medical treatment has been a significant factor in causing the public health crisis.”

Nothing illustrates the folly of government policies better that the rising number of pain sufferers who turn to street heroin because they can no longer get legal medication.
— Chronic Pain Association of Canada

Ulmer was frustrated that the report didn’t more broadly address how efforts to prevent addiction and overdoses have harmed pain patients.

“The fact that addiction and overdose deaths continue to soar should convince them they have taken the wrong path. But it hasn’t. Now they have pain patients deprived of their medications, with reduced quality of life, increased pain, patients committing suicide, as they are no longer able to cope, with some seeking street drug dealers to see if they can find some relief,” Ulmer said.

“Nothing illustrates the folly of government policies better that the rising number of pain sufferers who turn to street heroin because they can no longer get legal medication.”
  
Ulmer said the report’s brief discussion of opioid medication was “illogical, gutless, and shameful” and called on the Canadian government to “cease their war on pain patients” by immediately withdrawing Canada’s opioid guideline – without waiting for a final report from the task force.

How Has the Coronavirus Affected You? Take Our Survey

By Pat Anson, PNN Editor

Are you worried about becoming infected with the coronavirus? Are you self-isolating at home? When you go out, do you wear face masks and gloves? Can you even find face masks and gloves?

Those are some of the questions we’re asking in a survey designed to measure the impact of the coronavirus on people living with chronic pain and/or chronic illness. PNN is partnering with the International Pain Foundation (iPain) and the Chronic Pain Association of Canada (CPAC) to see how people who are most vulnerable to COVID-19 are coping with a life-altering pandemic.

“We are all aware of the coronavirus and the effect it is having on our society as a whole. However, many don’t realize the negative effects it has on people living with chronic pain. Chronic pain sufferers often have conditions that render them more vulnerable to this virus than the general public. And we are concerned about access to vital medical services and medications that patients require on an on-going basis,” says Barry Ulmer, Executive Director of CPAC.

“It is important that as many people as possible take the survey. That will allow us to measure the impact of COVID-19 on people with chronic pain or chronic illness and then address those problems with our policymakers and regulators. This is important so please take a few minutes to participate.”

“People with chronic conditions are more vulnerable to catching a cold, viruses and other communicable diseases,” says Barby Ingle, the founder and president of iPain. “Many are isolated at home, have little contact with the outside world, and are unable to get protective gear such as masks. That increases their anxiety and stress, which can worsen their underlying condition.

“More personally, as a pain patient who is at high risk for the coronavirus, I would love to connect and evoke discussions with people who are dealing with a dehumanizing experience.”

Vulnerable Populations

Who is most vulnerable to COVID-19? A study of people infected in China found that those over the age of 80 have the highest fatality rate of any age group -- nearly 15 percent -- followed by people in their seventies (8%) and sixties (3.6%).  The study found that cardiovascular disease, diabetes, chronic respiratory disease, hypertension and cancer also raise the risk of death.

The CDC goes a bit further, warning that obesity, smoking, poorly controlled HIV or AIDS, and prolonged use of corticosteroids, prednisone and other immune weakening medications also increase the risk.

In a recent column, Dr. Lynn Webster suggested that chronic pain may weaken immune systems.

“People with chronic pain may be more susceptible to viruses in general, because chronic pain can change the way our immune systems work. McGill University researchers found that chronic pain changes the DNA in T-cells, a type of white blood cell essential for immunity. Researchers were surprised by the number of genes affected by chronic pain,” Webster wrote.

Our survey should only take a few minutes. You’ll be asked a series of multiple-choice questions. Select the answer that best describes your situation or leave it blank if no answer applies to you. You'll have an opportunity at the end of the survey to provide more detail or discuss other issues and concerns.

To take the survey, click here. Your feedback is important!