North America’s drug-overdose epidemic killed tens of thousands of people last year. Some 4,000 people across Canada and 72,000 in the United States. Most of those deaths involved opioids: either a prescription painkiller like OxyContin, heroin purchased on the street, or, increasingly, a more-potent synthetic opioid called fentanyl.
As authorities have struggled to find an effective response, they’ve created a second group of victims, and one that receives significantly less attention.
Rather than overdosing on opioids, members of this group don't get enough drugs.
They are people who live with severe and chronic pain. For them, opioids are a miracle without which many feel they cannot make it through the day.
A contributing factor to the initial development of North America’s overdose crisis was an oversupply of pharmaceutical opioids that doctors prescribed for pain. Beginning in the 1990s and through the 2000s, millions of people were prescribed opioids without sufficient justification and in volumes that were unnecessary. In turn, some patients became addicted. Others left unused pills at the backs of their medicine cabinets. Teenagers found them there and eventually became addicted that way.
Health-care professionals eventually realized their error and regulatory authorities moved to end overprescribing. Then, as doctors stopped writing prescriptions for opioids, people who were taking those drugs for legitimate pain became collateral damage.
“The Unseen Victims of the Opioid Crisis Are Starting to Rebel,” reads a recent headline in Wired.
The article goes on to describe the rise of a new protest movement, where pain patients are calling attention to the unintended consequences of authorities’ crackdown on prescription pills.
“The campaign to keep opioids away from people who abuse them has ended up punishing the people who use them legitimately—even torturing them to the point of suicide,” it reads. “Now they are pushing back, mobilizing as best they can into a burgeoning civil rights movement. ‘Don’t Punish Pain’ rallies are taking place in cities nationwide on May 22, and pain patients are organizing a protest at the Centers for Disease Control and Prevention in Atlanta on June 21.”
The movement appears to stop at the border. There are no similar demonstrations planned for anywhere in Canada. But the problem is unfolding in Canada to the same extent it is in the United States.
In March 2018, the Straight published an in-depth report on B.C.’s “opioid refugees”, the term that’s sometimes used to describe this group of patients that’s increasingly forced to endure pain without treatment.
A Nanaimo drywaller and chronic-pain patient named David Reid shared his story. He recounted using a small dose of OxyContin to help him get through painful days on the job. Then, in response to B.C.'s overdose crisis—in which the vast majority of deaths involve illicit fentanyl, not prescription pills—Reid was cut him off.
"I don’t write prescriptions for oxycodone or for any other opioids," his doctor told him.
“North of the border, many people believe that the opioid crisis is playing out the same as in the U.S.,” that article explains. “That's because Canadians watch CNN and read American newspapers, and the effect has been for important regional variations in the crisis to be glossed over and confused. In response to media reports that focus on the U.S., Canadian doctors have received increasingly intense criticism and pressure to scale back opioid prescriptions. This has left patients like Reid—people with real pain who just want to get through a hard day’s work—with nowhere to turn for the medicine they need, except maybe to the streets.”
Pain B.C. executive director Maria Hudspith spoke to the Straight for that story.
“There has been a pendulum swing around opioids,” she said then. “And now there are definitely people who live with chronic pain who are reliant on opioids for pain relief who can no longer access them.
“Is less opioid prescribing a good thing? I think a lot of people would say ‘yes,’ and this pendulum swing is accomplishing that,” she continued. “But I think the outstanding question is, are there people who have been harmed by this reduction in prescribing? I would say, definitely, yes.”
Vancouver and cities across Canada now host several protests every year that call for greater government action on overdose deaths. Demonstrations organized by patients denied opioids for pain might come next.