Dr. Andrea Furlan, Associate Professor of Medicine at the University of Toronto, commented recently that pain management is at the core of Canada’s opioid crisis and the key to a solution.
In an article originally published in "The Conversation", an independent and non-profit Academic Journal and reprinted in the National Post, Dr. Furlan noted that two people die every day in Ontario from an opioid overdose. The prevalence of opioids and the physician’s prescription notepad share the responsibility.
"These deaths are less surprising when you consider that pain is a normal part of human life, and physicians have been told to prescribe opoids to eliminate it. Staggeringly one in seven people in Ontario were prescribed an opioid at least once in 2015-16."
In addition to being an Associate Professor of Medicine, Dr. Furlan is also a Senior Scientist at the Toronto Rehabilitation Institute. "I have researched pain for more than 20 years and I believe that opioid therapy is only appropriate for a very small number of patients with chronic pain. I don’t believe that there’s any need for 14 percent of Ontario’s population to be on opioids."
She is calling on physicians, rehabilitation and pain management specials along with Governments and Pubic Medicare Plans to adopt a 'national strategy on pain management'. This strategy would differentiate between acute short term pain and chronic pain—and devise the appropriate prescription plan.
"Acute pain is the normal response to a harmful stimulus when the pain system is functioning well", says Dr. Furlan. "Hurt results from harm. The key is to prevent 'acute pain' from becoming 'chronic'. Chronic pain that is caused by an ongoing stimulation of the normal pain pathways requires treatment to eliminate the harmful stimulus."
Dr. Furlan notes there dozens of strategies and ways of preventing acute pain becoming chronic pain without the use of opioids. "As a society we need to adjust our expectations about how much pain we must treat aggressively, and when to stop treating. Patients, caregivers, decision-makers and educators need more education about what is pain, the multi-dimensional nature of pain and the proper management of pain."
The other big push is for gentler, non-addictive pain management drugs to treat symptoms of both 'acute' and 'chronic' pain. Bio-pharma research companies like Medipure Pharmaceuticals will be the keys to this strategy. Their ongoing research and testing of natural and synthesized molecules targeting the endocannabinoid system will lead to a new generation of safe pain-killing medications. This will offer physicians and their 'prescription note-pads' a critical alternative to opoids.
And the risk of opioid addiction and overdose deaths is tragic and very real, for patients, families and physicians. The time has come for a national conversation on pain and how to deal with it. Concludes Dr. Furlan: "A National Pain Strategy is needed because pain, especially chronic pain is dehumanizing, debilitating and costly."