Saturday, 18 November 2017

Opioids -damage control in a nation of victims.

   "Something," think the social warriors, "must be responsible for the lethal epidemic of opioid addiction (and almost every other form of addiction).  God knows, those suffering from every physical and mental pain that the human flesh is subject to, could not be to blame.  In fact, when it comes down to it, they must be the victims.  It must be the fault of those bloody rich, privileged physicians, brainwashed and bribed by the drug companies, that put patients on whatever medication will get them out of the office as quickly as possible."
   You may think I  am being flippant, but that's exactly what many folks think and are encouraged to think, by our elected leaders and their bureaucrats, in order to divert blame from  themselves.   It does not occur to them, or bother them that patients who are awaiting surgery for an excruciatingly painful hip or back,or whatever, are suffering during a deliberate two year waiting list and need serious relief from  their pain.   That the mild to moderate analgesics that their physicians start them on become less effective after a while and physicians are forced to titrate their patients pain with the most effective medications that are available to relieve it.   It does not occur to patients that the very lengthy waiting lists is a deliberate policy by their elected representatives to cut the health care budget under the pretense that it is due to a shortage of physicians and nurse.  It is not, it  is due to misallocation of funds that results in surgeons unable to get operating room time, despite empty operating rooms and nurses being unemployed.   They certainly don't consider Canadians first in allocating tax dollars, so we see the ridiculous payouts to terrorists and others to whom they dispense huge sums that would be available to treat our failing health care system.   They continue to  generate layer after layer of  administridiots,  who convince themselves that they are the health care providers and that doctors and nurses are simply their serf technicians That is why we, in Canada, are at the bottom of  the list in quality of health care, in almost every category, compared to other developed nations.  When physicians and nurses ran the health care services we were near the top.  
   When  patients are in  pain, physicians and nurses will do almost anything in their power to relieve pain  and  suffering.   So, a patient who is on a two year waiting  list and visiting their physician regularly, complaining quite justifiably of constant disabling pain, expects to have their pain relieved.  The administridiot, who never comes face to face with the patient, and is oblivious to the patient's suffering suggests that physician's cavalierly dispense narcotics to get the patient out of  his office or for financial gain.   No, the physician sitting across from the patient is trying to help the patient, to relieve his pain.  He/she tries to do this without addicting the patient to pain relieving drugs and sometimes this is interpreted as callousness, or indifference to patient suffering.  The College interpreted such complaints, whether justified or not as an 'under-prescription crisis' and instead of meticulously investigating and researching the situation began to 'educate' physicians to prescribe narcotics much more liberally, often assuming that addiction was rare in people who were prescribed narcotics liberally for the relief of pain.  Meanwhile opioid poisoning lands sixteen patients in hospital each day in Canada and there has been a 15% jump in the past ten years.  The administridiots continue to place the blame for this on physician prescribing habits and sometimes this is true and partly as a result of a concerted effort of educational organizations a few years ago that were encouraging physicians to prescribe narcotics very liberally to relieve non-cancer pain.  The results were disastrous, ranking Canada second only to the United States in opioid abuse.  In an attempt to correct the damage the Royal College of Physicians and Surgeons of Canada published the " 2017 Canadian Opioid Prescribing Guideline", a document so prosaic that a final year medical student could have written it.
   Meanwhile, what is the government of Canada doing?  Well, the Minister of  Health is planning to hold meetings on allowing different drugs such as heroin to be administered outside of  hospital settings: she plans to allow drug checking services at all authorized supervised consumption sites: she want the provinces to establish temporary overdose prevention sites. None of which is  likely to have much effect.
   In fact, there are some who recommend the decriminalization of all illicit narcotic use.
   Unfortunately, we are unlikely to make much progress in this area while the administridiots are making medical decisions that they are unfit to make.  The obvious first step is to rely on experienced health care professionals to develop whatever solutions may be available.
   Making marijuana and other drugs available for recreational purposes is going to compound the problem, not alleviate it.

Comment if you have any views on  this.

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