Chronic pain sufferers face 'drug-seeking' stigma

As changes to rules on OxyContin prescriptions have dominated headlines over the past week, a Thunder Bay physician says the publicity around narcotics addiction can add to the stigma facing patients suffering from chronic pain.

Thunder Bay doctor says patients fear being judged for using narcotics to deal with pain

Thunder Bay family doctor Bryan MacLeod

As changes to rules on OxyContin prescriptions have dominated headlines over the past week, a Thunder Bay physician says the publicity around narcotics addiction can add to the stigma facing patients suffering from chronic pain.

Family doctor Bryan MacLeod, who recently joined the chronic pain management team at St. Joseph's Hospital, said chronic pain robs people of their livelihoods and activities they enjoy. And, he added, they often face public judgment.

"The person … smiles out in the community because they're happy in that moment," MacLeod said. "But they're not allowed to smile because they're off work because of pain."

MacLeod noted many patients already feel a lot of stigma about the medication they use.

"Part of the difficulty that they … have been perceived as ... drug seeking, or … fear that they might be perceived that way," he said.

Negative perception fuels anxiety

Karen St. Jacques, a physiotherapist with the chronic pain management team, said when patients are anxious about their prescriptions they can feel even worse.  

"If anxiety builds, it has lots of implications, [such as] muscle tissue tension, [poor] sleep, [and] coping strategies," she said.

Both MacLeod and St. Jacques emphasize that medication is only one of many ways to manage chronic pain, and patients can turn to the chronic pain management program for help.

St. Jacques said the team's goal is to give patients the tools they need to manage their pain, and put them at the centre of their own care.

"They're not a passenger to the pain, but [we are] giving them the driver's seat to taking control," St. Jacques said. "It's not their doctor that's driving, it's not their physio that's driving, [and] it’s not their massage therapist or their counsellor that's driving." She said direction from all of these health care providers is important, but it’s the pain sufferers themselves who need to take on dealing with the pain in their own lives.

Lack of family doctors adds to concerns

MacLeod added it’s important to recognize that patients dealing with chronic pain are often afraid of being judged for using prescription painkillers and are afraid of losing access to the medications that help ease their pain.  

"It's in the forefront of the mind of the physicians who are trying desperately to help people with their pain," MacLeod said. "But, at the same time, [they] don't want to do any harm, don't want to ... put a person in the risk of addiction."

It’s a scary time for patients like Sherry Tougas, who cracked her vertebrae in a diving accident about 40 years ago.

When her Thunder Bay family doctor retires, she will no longer have a physician who can monitor her prescriptions for Percocet and low doses of morphine.

"I'm scared to death now," Tougas said. "Without ... another family doctor I have no pain medication, like no opiate-type pain medication, as of the 31st of May."

Tougas said she is considering seeking a referral to the chronic pain management program with the hope it will help her find new ways to manage her pain.

MacLeod said Thunder Bay's family doctor shortage is a challenge for the chronic pain management program. About a third of the program's patients don't have a primary care provider. MacLeod said having a family doctor is important for continuity of care after the patient completes the six-week program.