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March 29, 2012
Eye View
As the war on drugs drags on, a powerful narcotic has slipped through the radar.
When OxyContin was introduced in 1996 it was a godsend for the six million
Canadians who suffer from pain. It quickly grew to be one of the most prescribed
drugs in Canada, so common that it was passed on to friends and family for
non-medical use and eventually sold on the street.
The tradeoff of pain-relief for narcotic use is a Faustian transaction. One of
the sufferers interviewed on CBC's Fifth Estate, Tammy Dagnall, told of her
chronic pain from a car accident. OxyContin allowed her to work, no longer
disabled by pain. However, she began to feel so good that she wanted to feel
better. That attraction was too much for Dagnall and soon she was using ten
times the maximum recommended dosage.
Dagnall was using so much that that she realized she was hooked. So she decided
to quit OxyContin and quickly discovered that it wasn't that easy. Dagnall's
dilemma was one that many more Canadians are about to discover, now that it's no
longer sold here. When you are addicted to OxyContin, it's almost impossible to
stop. "The sickness is unbearable," she agonized. Life on an excessive dose of
the drug left her in a zombie-like haze but life off it was hell. Her habit
finally led to the breakup of her family.
Thousands of Canadians who use OxyContin for non-prescription purposes are about
to find what hell is like because provinces are removing OxyContin from pharmacy
shelves. It's being replaced by OxyNeo which is harder to crush and more
difficult to inject or snort.
It's simplistic to think that removal of a drug which thousands of Canadians are
addicted to will make the problem go away. Some addiction experts worry that
removal of OxyContin could send addicts into sudden withdrawal and force them in
desperation to turn to even more harmful drugs to relieve their agony.
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How do you balance the need for pain control with the risk of abuse of
OxyContin and its replacement, OxyNeo? That's a dilemma that pain specialist
Dr. Roman Jovey told the Fifth Estate he struggles with. How could he refuse
to relieve the pain of patients when the treatment is available?
Regrettably, the Fifth Estate paints Dr. Jovey as having sold out his ethics
to the manufacturer of OxyContin because of funding he received for
publishing a handbook on pain management. That easy judgment is so
predictable.
Because a doctor endorses a drug that successfully manages pain does not
make him an accomplice to the industry manufacturers it. Dr. Jovey carefully
assesses each patient in an attempt to determine whether their pain is
emotional or physical before prescribing. It's a delicate balance between
pain control and addiction.
I found Dr. Jovey to be credible and so does Dr. Ketan Patel, specialist in
Pain and Addiction Medicine, in London, Ontario. "In 2003, he taught me
foremost to implement a BALANCED approach to pain care (through the use of
both drug and non-drug techniques)," writes Dr. Patel in the comments
section of the Fifth Estate. "This episode was incredibly myopic in the way
it portrayed him."
Another of Dr. Jovey's patients, Marty Whittaker, exemplifies that balance.
She was in unbearable pain after she broke her back in a water-skiing
accident. "I'm dependent on OxyContin as I am on my glasses to see." She is
now able to walk the fine line between addiction and medication. "I'm
habituated to the medication not addicted. While pain exists in my body,
addiction is impossible."
David Charbonneau is the owner of Trio Technical.
He can be reached at
dcharbonneau13@shaw.ca
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