B.C. aims to implement provincial pain strategy: patients' advocate

VANCOUVER - The British Columbia government is working on a provincial pain strategy that would provide greater access to services for chronic conditions such as arthritis, back pain and fibromyalgia, the head of a patients' advocacy group says.

Maria Hudspith, executive director of PainBC, said a draft strategy has been completed for Health Minister Adrian Dix after consultations by his ministry with her group, patients, clinicians, researchers and the College of Physicians and Surgeons of B.C.

Hudspith said input included initiatives and policies that have worked elsewhere, including Australia, which has a national pain strategy.

The strategy would set out guidelines for treatment and establish a connection between family doctors and other experts dealing in chronic pain and the use of opioids.

Ontario and Quebec are among provinces that have made investments in treating chronic pain by teams of experts such as primary care physicians, nurse practitioners, physiotherapists and social workers as patients' groups work to create co-ordinated pain management services.

“We are seeing provinces in different stages of development and we are the most far along in terms of having the most comprehensive strategy that I've certainly seen,” Hudspith said of B.C.'s draft pain strategy.

The Health Ministry said it is continuing to consult with stakeholders but did not provide details about its plans.

Researchers, clinicians and patients gathered in Vancouver last week as the annual Canadian Academy of Health Sciences called for a national pain strategy that would ensure regulatory standards are in place.

Hudspith said a national strategy would provide common policy standards for all patients.

“My worry is that we're going to see this huge disparity across the country, where in B.C. we eventually get our provincial strategy and we have a lot of movement and positive change here but many other provinces, they have nothing.”

Health Canada said it is committed to working with the community though Health Minister Ginette Petitpas Taylor has not committed to a national pain strategy.

“The minister of health has asked departmental officials to consider a task force on pain to identify strengths, challenges and gaps in prevention and management of chronic pain in Canada,” the department said in a statement.

Hudspith said any strategy must include issues involving opioids and how to prevent patients from taking too much medication following surgery, for example.

“If somebody is six weeks post surgery and they're still having significant pain and they're still taking significant amounts of opioids that's the kind of thing where there should be some intervention and dedicated support to prevent that from going down the wrong road.”

Carley Ouellette, 23, has suffered from chronic pain since age 12, soon after her left arm was injured when she was hit by a car while riding her bicycle.

About six weeks later, after her cast was removed and she started physiotherapy, Ouellette was a passenger in the front seat of her mother's car when she braced for impact during a crash.

Excruciating pain had her going to her doctor, walk-in clinics and emergency departments, but without anyone understanding her condition.

“My arms was going completely blue and it was locking. I couldn't move it, anything was painful to touch, even the touch of clothing. I couldn't be touched so my mom couldn't hug me.”

Ouellette was eventually diagnosed with complex regional pain syndrome, a hypersensitivity for which she received care from a team of experts at the Hospital for Sick Children in Toronto.

Ouellette, who is a cardiac surgical research nurse in her hometown of Hamilton and is completing a masters of science degree in nursing at McMaster University, is also a patient advocate with the Chronic Pain Network and attended the meeting in Vancouver last week.

She said she takes an opioid and other medication when necessary and exercises regularly while continuing to get nerve blocks that involve injections to decrease inflammation and numb pain, enabling her to function.

“I'm a very fortunate case in that I was able to get into the chronic pain clinic as a result of being a pediatric patient but there are wait lists for chronic pain clinics, which, I might add, are few and far between,” Ouellette said, adding some patients wait two to three years for an appointment at a pain clinics.

“Chronic pain affects one in five Canadians so that's a huge proportion of Canadians that experience some sort of persistent pain every single day.”