Good afternoon, Mr. Chair, and esteemed committee members.
This is the third time I have presented before this committee on pain issues, representing the Canadian Pain Coalition. The CPC is a partnership of people living with pain, pain organizations, health organizations, health professionals treating people in pain, and scientists looking for better ways of managing pain.
Our primary goal is to promote the sustained improvement in the understanding, treatment, management, and prevention of all types of pain in Canada, and we do this through our national awareness initiatives. We provide education for individuals living with pain, and we advocate for improved pain management.
The Canadian Pain Coalition commends the Standing Committee on Health for undertaking its study into the extremely serious issue of prescription medication abuse in Canada. The CPC is confident that in its recommendations this committee will strongly balance providing appropriate pain management for Canadians with reducing risks and devastating harm from prescription drug abuse and deliberate misuse. CPC's role in this discussion is to provide the person-with-pain perspective, and highlight for your consideration who is affected by pain, the burden of pain, and what Canadians need for effective pain management, which often includes the use of prescription pain medication.
The CPC is committed to working towards determining and implementing solutions to these problems. Canadian research reveals that under-managed pain is in epidemic proportion in Canada. Those affected include one in five, or almost seven million Canadian adults, including our veterans. One in five Canadian children have weekly or more frequent chronic pain like headaches or stomach aches. There are 5% to 8% of our children and teenagers who suffer from chronic pain severe enough that it interferes with school work, social development, and physical activity. All people associated with the individual living with pain are impacted, with the greatest devastation most common in families. Among these populations are individuals who may develop or who are currently living with the disease of addiction.
The burden of pain is staggering. Pain costs Canada an estimated $56 billion to $60 billion annually in lost productivity and health care costs. Costs for individuals like me are approximately $17,000 each year in lost income and out-of-pocket expenses for treatment modalities that are not covered.
The stigma of being labelled as malingerers, drug seekers, druggies, and pushers is denigrating and disempowering. The backlash continues to grow, creating fear of taking medications that could reduce pain and improve functioning as part of a well-rounded pain management plan. Misunderstandings about pain, like the difference between addiction and physical dependence on a medication, fuel fear of becoming addicted to pain medications. This negatively impacts compliance in taking prescriptions, or accepting prescriptions that could reduce pain.
Chronic pain happens to average, honest people, to someone you know, to someone you love, to someone who looks like me. This disease negatively impacts every aspect of a person's family, work, social, school, personal, and spiritual life. It dramatically reduces our quality of life and well-being. At the very least, living with under-managed pain is devastating and demoralizing. At its worst it is depressing, disabling, and dehumanizing. It can turn deadly, as research tells us that people with pain have double the risk of suicide compared to those without chronic pain.
The burden of pain is overwhelming and likewise is the need for effective, best-practice, multidisciplinary pain management, which is not provided by Canadian health systems. We have the knowledge and we have the technology, but we cannot get it to the patient within the current structures. For instance, physician visits are covered, while access to other pain-relieving modalities, such as physiotherapy, occupational therapy, and psychology are dependent upon having extended health benefits or the ability to pay. Many Canadians with chronic pain have neither. As a result, there is a heavy reliance on prescribed medication as treatment for chronic pain, while research has revealed that pain relief may be as little as 30%.
When their pain is not managed, individuals return to their doctors, such as Dr. Buckley, who may decide to provide other or stronger medication. Again, the relief provided is not enough.
Many Canadians believe that pain medication is their only option. A CPC 2010 survey revealed that 45% of people suffering moderate to severe chronic pain believed that there was nothing that could help them with their pain. Out of desperation, the person may use more medication than prescribed, or they may combine over-the-counter medications with their prescription. A dangerous vicious cycle can develop. People can encounter that slippery slope, which no one intends to happen, unless awareness and accessibility of other management options are made available. Sadly, some individuals take their own lives with the very medication that they expected would relieve their pain. This happening to one person is one too many. Sadly, I know of many.
Experience shows us that effective pain management occurs when a personalized combination of health care modalities are working in concert with learned coping strategies, the person's knowledge of their chronic pain condition, an attitude shift, and lifestyle adaptation. People will experience an increase in their quality of life, their productivity, and their functioning when all the pieces of a pain plan are working together.
Of key importance to this inquiry is the fact that, based on each person's success, pain medication dosages are often used more effectively or may be reduced. Length of reliance on medications may also be reduced or even eliminated as other pain strategies are successfully integrated into one's lifestyle.
Canadians living in pain require timely and best practice delivery of acute pain and chronic pain treatment within our health systems. We need health professionals who receive standardized training in effective pain management and who are supported to subscribe and monitor appropriate medications for individuals with and without the disease of addiction. We need them to be using best practice guidelines.
Individuals with pain require the widest variety of prescription medications for their pain, because a medication that provides relief for one individual may not work for another. As well, combining medications with different mechanisms has been shown to dramatically reduce pain.
People with pain require improved pain education opportunities so that we can make informed decisions, take responsibility for becoming actively involved in our pain management, and feel equipped to create a pain plan and to work our pain plan every day. This education would include the benefits, risks, and realities of taking prescription medications for pain, as well as prescription safety to prevent harm to others. We can get involved in that. The public education and working group of the national faculty associated with the DeGroote National Pain Centre and the Canadian Pain Coalition have created just such materials for people living with pain.
Medications play a key role in chronic pain management for Canadians. A balance must be struck to provide access to medications within a well-rounded pain plan while ensuring protection against potential harm for the patient and others. This is not a simple task, but one that is necessary for the well-being of all Canadians.
The 2012 national pain strategy for Canada, a document that CPC helped to create and launch, and best practice guidelines—