Bad and Distorted Research Used By Health Canada Leads to Tragedy for Many Canadian Patients

For Your Information
Edmonton, AB
July 8, 2019

In order to deal with overdose deaths among illicit drug users, Health Canada decided to go after chronic pain patients and their doctors this in the purported belief that they could reduce deaths. The department’s website, press releases, TV advertising, and the Minister’s statements all make clear that Health Canada is blaming part of the increase in overdoses on some imagined increase in the use of prescribed opiate medicines by Canadian patients. Prescribing of these drugs in Canada has, in fact, plunged.
Beginning in February 2018, the Chronic Pain Association of Canada (CPAC) attempted to find out from Health Canada what was informing their claims and actions. After several written requests with no reply, CPAC simply asked – What is it that you are basing your continual claim on that prescription opiates are to blame for your said “opioid crisis”?
In addition to written requests for answers, we also visited the offices of MPs, sent e-mails and made phone calls. Near the end of 2018, we sent the Minister a user-friendly synopsis of applicable research. Finally, in December 2018, we received a reply and found it wanting. We spent some time re-evaluating the studies they provided as their proof (we already knew them) and wrote back with our analysis.
We were quite surprised at how bad their grasp of the available research was.
Everything they referenced acknowledged that illicit drugs, not prescribed opiates, are driving overdoses. None of it provides any basis for curbing prescriptions. Ottawa’s own “Opioid-Related Harms in Canada” (2017) states that opiate-involved hospitalizations increased 53% in the ten years since 2007—bringing us to a rate of just 0.015% a year. The report specifies that most hospitalizations involved heroin and synthetic opiates like street fentanyl, not drugs prescribed by doctors. That’s been confirmed repeatedly by the coroners of BC and Alberta, with the latest BC numbers showing involvement of street fentanyl in a full 92% of overdose deaths, most of which also involve a mix of other street substances. Alberta numbers likewise show fentanyl driving 89% of deaths.
The report also says the fastest rise in hospitalizations is in young people, owing to street drugs and suicide attempts. There’s no basis here for curbing prescriptions, which most often go to older people.
Health Canada also cited a study that estimated that 83,000 adults used a prescription opiate in 2015, but not for pain. This data is from unreliable self-reporting. And that’s also just one quarter of one percent of us—not much on which to hang the one million Canadians desperately needing these medications.
Likewise, they cite their own 2016-2017 Canadian Student Tobacco, Alcohol, and Drugs Survey to say that 61,000 kids said they used a prescription analgesic to get high. The survey says the rate is stable; they don’t mention that. And, like the other stat above, the number reads quite differently when put into perspective: it’s a mere 3% of kids, and pretty benign compared to the more than 250,000 kids—four times as many—who tried cough syrup, Nytol, Gravol and the like to get high. And so these surveys also provide no basis for curbing prescriptions..
They ended their rationalization by citing four papers by Canadian “scientists.” But three of these are from researchers caught fudging their conclusions: last year, acting on complaints by readers of an online draft, the editor-in-chief of the medical journal PAIN made David Juurlink and Tara Gomes strike intentional distortions from a paper they’d submitted. Juurlink and Gomes write and speak frequently about the supposed dangers of medically-managed opiates. News media seems to believe Juurlink is an authority on the subject, given how often they quote him.
Our reply pointing out these problems went to the Minister in April. She has not responded.
Based on the faulty and misinterpreted research Health Canada used, the majority of Canada’s one million intractable pain patients who have successfully relied upon opiates to deal with their pain have had their medications discontinued or drastically reduced. Patients who had been doing well for years are now attempting to cope with significant increases in their pain and significantly reduced quality of life. They and their families are devastated.
The Food and Drug Administration in the US, the Centers for Disease Control, the authors of the American opiate prescribing guideline on which Canada’s is based, the US Health and Human Services Department, and even the Surgeon General have all publicly acknowledged that cutting pain patients down or off their medications has been wrong, unethical, and dangerous. Numerous US medical organizations including the American Medical Association have spoken out against the practice.
In fact, we wrote to the minister and called on her publicly to change her prohibition policy based on what the US has done. One of our press releasescalled upon the Minister to restore proper treatment to pain patients just as some doctors are prescribing opiates to addicts to keep them safe. No reply!
Neither Health Canada, the authors of the Canadian opiate guideline, nor the Canadian Medical Association have uttered one word. As pain patients are thrown into disability and more suffering, Health Canada policy has also increased the death toll. Pain patients have died from medical collapse, suicide, and now from the poisoned street drug supply that more and more are turning to out of desperation as they lose their managed care.
Health Canada’s response to this devastation has been to set up a Task Force to report back in three years. And, as in 2016 when pain experts and patients were shut out of the federal opioid “summit,” once again pain experts and the severely pained remain excluded without explanation from this new panel.
The Chronic Pain Association of Canada again calls upon the Minister of Health to rectify the dire problems they have caused and to help pain patients regain their health and lives.
The Chronic Pain Association of Canada receives no public or industry funding and believes in treating pain by whatever method works.

Contact: Barry Ulmer, Executive Director Chronic Pain Association of Canada
Telephone (780) 482-6727 | Fax (780) 433-3128 Box 66017 Heritage Postal Outlet, Edmonton Alberta T6J 6T4 Chronicpaincanada.com | cpac@chronicpaincanada.com

Filed under: General Problems