The Alberta Government’s war on opioids is turning into a war on patients instead. Here are some of the issues we need to talk about:
Issue #1: There never was an opioid crisis. When a private group first published their opinion on reducing maximum opioid prescriptions, the U.S. Food and Drug Administration (FDA) reviewed the proposal, then issued a statement that the research was flawed, the conclusions invalid, and that the FDA would not support the proposal. It got approved anyway. And, in a recent article written by CDC officials in the American Journal of Public Health, they admitted that “death certificate data does not always differentiate between legal and illegal drugs, so fatalities resulting from illegal fentanyl is being counted as a legal opioid deaths.” In reality, it appears that overdose deaths from legal opioids have been overestimated by about 43 per cent.
Issue #2: As opioid prescriptions decline, deaths related to opioids jump higher. Jacob Sullum, writing in Reason magazine, shows that opioid prescriptions peaked in 2011, and since then have declined by roughly 38 per cent (2016), yet deaths from opioids have increased (108 per cent), from heroin (311 per cent), and from synthetic opioids (414 per cent) over this same time period.
Issue #3: Opioid use is not the problem. Drug abuse involving multiple drugs is the problem. California’s Department of Health and Human Services shows the average number of drugs found in overdose victims was six. This is about chronic abuse of multiple drugs (legal opioids, heroin, fentanyl, and alcohol amongst others), not a pain patient trying to reducing suffering for one more day.
Issue #4: Roughly 1 per cent of patients become addicted to painkillers. And, again from Reason magazine “even when patients take opioids for chronic pain, only a small minority of them become addicted.” Further, researchers at the University of North Carolina reported that of 2.2 million residents of the state who were prescribed opioids, the overdose rate was only 0.022 per cent.
Issue #5: Deaths from opioid overdoses need to be compared to other causes. Overdose deaths in America are estimated to be less than 17,000 a year (still a frightening statistic) but 34,000 people in America die each year from accidental falls. Do we have an opioid crisis, or do we really have an accidental fall crisis?
Issue #5: The war on opioids is not working. As pain patients are denied access to the painkillers they need, they have little choice but to use illegal drugs, including heroin and fentanyl. Because they are illegal drugs, the quality and dosage of the drugs are not known, and overdose deaths skyrocket (as we noted in Issue 1 above).
Most people I talk to are reasonably educated and intelligent individuals, and virtually all of them agree with the statement that “complex problems usually require complex solutions.” Simple solutions do not work, and a lot of Albertans are suffering, needlessly. Pain is a complex subject, and people have different reactions to similar levels and types of pain, but once again, our health officials are sticking to one simple number based on American research believed to be wrong. It’s time for Alberta’s minister of health to put an end to the war on opioids and patients.
Brian McLeod is a St. Albert resident.
