The Current

'Silent epidemic': How a doctor is changing the way we treat pain

Dr. Hance Clarke is challenging our approach to managing pain and getting people off addictive opioids at the same time.
In the first six months of 2016, there was an 11 per cent jump in the number of people who died of opioid overdoses in Ontario. (John Moore/Getty Images)

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In the province of B.C. alone, it's estimated there will be 1,300 opioid deaths by the end of this year.

New guidelines say doctors should only prescribe opioids in very specific cases of chronic pain and they should also try to wean their patients off opioids altogether.

Pain specialist Dr. Hance Clarke is doing just that — getting his patients off addictive opioids.

He argues the root cause of the opioid crisis is the approach to pain management and he's calling for a radical overhaul in how we treat pain — something he refers to as a "silent epidemic."

"We need to move to this shift in asking people how they function, asking people what is most important to them and looking at their disability," Dr. Clarke tells The Current's Anna Maria Tremonti.

By resetting goals, he explains that doesn't necessarily mean pain medications and opioids aren't part of the solution —  "it means we start to prioritize how we get to that end goal of better functioning, less disability and ultimately, potentially as well a reduction in that pain over time."

Dr. Clarke warns that although some pain will reduce over time, not all pain will go away and it's something people in chronic pain need to understand.

He suggests it's about setting tangible goals to help regain a better quality of life and explore how to manage living with the pain in a way that will move towards reclaiming your life.

"Because just getting your life back is a big concept ... being able to do two or three meaningful things over the next three or four weeks —  that's an attainable target."

It is one of the reasons why he has an issue with rating pain from one to 10. He says this approach is built on a pain treatment algorithm on reducing intensity —  a method clinical trials use to evaluate a 30 per cent reduction in pain. 

But this method ignores the value of experience and doing more in life.

"We're being judged on how have you decreased that patient's pain intensity, not 'What are you doing today?' So in the next three months, if your pain is the same number but now you're attending social gatherings, you're cooking a meal for your family, these are things that there was no value in, " Dr. Clarke argues.

"And now we have to bring that back as the central core to managing people as we move forward."

Listen to this segment at the top of the web post.

This segment was produced by The Current's Willow Smith.