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The patient perspective: one chronic pain patient’s experience with prescription opioids

Messenger, Prescribing, September Messenger 2019 | Posted September 12, 2019
Brian, an Albertan living with chronic pain, was diagnosed with Multiple Sclerosis in 1993, signalling the beginning of his journey as a chronic pain patient. Since then, Brian has received additional diagnoses, including arthritis and calcification of the spine, three ruptured discs in his back, and a broken L8 vertebra resulting from a car accident. “The pain developed from a series of four different events that compounded on each other,” says Brian.

Luckily, about eight years ago, Brian found his family physician, who built a trusting relationship with her patient by listening, providing accurate information and staying available until every question was answered.

“The very first thing she did was she said, ‘you’re on Dilaudid, which is a fast-acting pain killer, and you need to be on something slower and longer lasting,’ so she switched me to Hydromorph Contin and that worked extremely well,” says Brian. “It was her knowledge, it was her patience and it was her thoroughness. I have often told her that she has saved my life, and I honestly believe that.”

For about five years, he continued taking Hydromorph Contin with positive results and an improved quality of life. In 2018, he received a referral to Dr. Omar Rahaman, who has an extensive background in pain management and caring for patients with chronic pain. “I think there’s a lot to be learned about pain management from [Dr. Rahaman],” Brian shares.

At this appointment, his Hydromorph Contin prescription was changed to Suboxone. “Initially [Suboxone] worked pretty well, but fairly quickly it started to diminish and by late 2018, it wasn’t working at all,” he says.

A champion for his own health

Despite having tried alternate therapies recommended by his physicians to help minimize his pain, such as exercise, physiotherapy, swimming, acupuncture and natural supplements, nothing was providing him with any relief.

“I could barely walk, I was hunched over like the Hunchback of Notre-Dame, I would walk 50 feet and would have to sit down,” explains Brian. At one point, he believed that his three grandchildren were the only reason he remained alive-without them, he felt that he most likely would have taken his own life.

Being a champion for his own health and feeling that his chronic pain was no longer being effectively managed, Brian sought the help of his physicians.

On a follow-up visit with Dr. Rahaman, Brian made it clear that the Suboxone was no longer working and that his quality of life was being negatively impacted because his pain was so intense. Much to his relief, Dr. Rahaman put him back on Hydromorph Contin. “It’s been a real life saver for me… the pain is a fraction of what it was.”

In July, Brian read CPSA Registrar, Dr. Scott McLeod’s message to Albertans about opioid prescribing and felt encouraged by this public commentary to start further discussions about his treatment plan with his physicians. He felt the patient perspective was missing in the opioid discussion and wanted to talk about the pressures he felt were put onto his own physicians regarding opioid prescribing.

Bringing Dr. McLeod’s message with him to help begin the conversation, the open and productive dialogue Brian was able to create with his physicians helped strengthen his relationship with them-it also helped Brian’s physicians better understand the degree to which chronic pain affects his quality of life.

“Only you as a patient know how much pain you’re under and, if it’s severe, then you need a solution,” he explains, “You’ve got to recruit [your physician] as an advocate for you,” says Brian. “Fortunately, I had a couple of physicians who I think were real advocates and really were concerned about this war on opioids and tried to do everything they could to help me through it.”

Brian believes that physicians genuinely care about their patients and don’t want to see them suffer. As a chronic pain patient, he knows that he needs to fight for his own health but also have open, honest discussions with his physicians so they can give him the best care possible.

Brian encourages other chronic pain patients to build a trusting relationship with their physicians and have these important conversations in order to ensure the physician has a good understanding of the amount of pain the patient is in. “What’s really important for physicians to know is that pain is different for everyone,” he advises.

Doctors know their patients best and need to be confident in their abilities to help them, even if it means prescribing opioids.


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