National Pain Strategy Update – Feb 2013

Canadian Pain Summit

The Canadian Pain Summit took place on April 24, 2012. The need for a Canadian Pain Strategy was widely endorsed and the blueprint for change was launched.  

Over 200 delegates attended, representing 131 professional and consumer groups interested in pain;

  • Health critics from the Liberal Party and NDP attended and spoke;
  • Ten media interviews were facilitated on the day of the Summit, including a national news feature qualifying the need for a National Pain Strategy
  • 272 earned media stories were secured for the National Pain Strategy through proactive media relations between November 2011 and April 2012;
  • Webcasting of the Summit and presentations are available for viewing at www.canadianpainsummit2012.ca

 

Parliament Hill Day

On April 23rd, 2012, a delegation including people living with pain and members of the Canadian Pain Coalition and Canadian Pain Society went to Parliament Hill to raise awareness among federal elected representatives about the need for a National Pain Strategy.  Accomplishments included:

  • Meetings with ten MPs from all three federal parties, including Opposition Critics for Veterans Affairs and Defence; Standing Committee on Health;
  • A successful meeting with the Office of the Minister of Veterans' Affairs, where staff expressed a desire to continue to collaborate and seek input for revisions to the Veterans' Affairs Act in 2013;
  • The Prime Minister's Health Policy Advisor has requested a future meeting with CPS / CPC representatives; and
  • Toronto Liberal MP Carolyn Bennett formally acknowledged the need for a National Pain Strategy in the House of Commons.

 

Online Engagement

In the lead up to the Summit, CPS was active on Twitter and Facebook, engaging patients, the public, and members of the media to raise awareness of the need for a National Pain Strategy.  During the Canadian Pain Summit, Twitter users posted approximately 643 tweets about the Summit or the National Pain Strategy, reaching an audience of over 474,000 viewers.  On Facebook, we reached an audience of 246,519. To further generate awareness among politicians and engage Canadians, we launched an online petition at www.CanadianPainSummit2012.ca encouraging Canadians to endorse the need for a National Pain Strategy.  Over 4,300 online signatures and over 3,100 letters to MPs calling for a more coordinated and integrated approach to the issue of pain.

 

The Goal

The goal is to have a National Pain Strategy implemented to address the four key target areas (awareness and education, access to care, research, and ongoing monitoring) to address the social, economic and personal impact of pain.  A National Pain Strategy will address the major gaps that exist including the fact that our health care professionals are not receiving adequate training in pain care.

What's Next?

We are encouraged by progress in other jurisdictions, such as Australia, which recently announced an additional $26 million in funding over four years for the New South Wales Pain Management Plan. The Australians held their Pain Summit March 11, 2010. They formed an organization called Pain Australia http://www.painaustralia.org.au/ a non-profit organization that was formed to help coordinate the implementation of the recommendations of the Australian Pain Summit.

Government Advocacy

We need to continue to educate Federal politicians about the huge burden of illness in Canada as a result of chronic pain and to persuade them to take a leadership role in supporting a National Pain Strategy.

At the federal level, it is important to continue to work with the Health Canada and Veterans Affairs Canada, as well as the Standing Committee on Health (HESA), to push for a task force to implement a National Pain Strategy.  It will be critical to have the National Pain Strategy put on a parliamentary committee's agenda for serious review and discussion.  Building on the relationships established at the initial meetings, it will be important to work with federal MPs to turn words and supportive sentiments into action, and have them endorse the Strategy and advocate for its implementation.

In 2013 we plan to shift our focus to the provincial level, beginning with a focus on engaging provincial ministries of health, MPPs/MLAs, and other relevant officials to push for action on the management of pain. This work has already started with many active individuals and groups working hard in British Columbia, the Atlantic Provinces, Ontario, Alberta and Quebec, advocating for better care for pain. We hope that all Provinces can help pressure their federal counterparts to ultimately implement a national strategy for pain.

Some examples of provincial initiatives that have already occurred since the Summit include:
In Ontario the ministry is developing a chronic pain plan for the province.  As a first step, they are compiling a comprehensive view of the services for the management of chronic pain currently offered.  This will identify gaps in services, review strategies that have been effectively adopted or are emerging in other jurisdictions, and will propose initiatives to support a comprehensive system in Ontario.  The Ministry is in the process of bringing stakeholders together.

Quebec continues to develop Centers of Excellence at Laval, McGill, Université de Montréal and Sherbrooke University. These centers will serve as tertiary care facilities for complex cases of pain and will support community practitioners treating people with pain.

Pain BC continues to pursue several educational initiatives including a live phone in radio show “Pain Waves Expert”, an annual conference, a community practice support program for GPs with a “hotline”  to the specialist and plans to create a mentorship program similar to the one on Nova Scotia, a coordinated strategy in the Interior Health Region and plans for expansion.

Nova Scotia continues to offer a province wide coordinated system of pain clinics and a mentorship network. The challenge is to increase hours of operation and to monitor outcomes of care.

We are planning a meeting of Provincial pain advocacy groups at the annual Canadian Pain Society scientific meeting in May 2013 in Winnipeg to share our successes and coordinate our strategies.

Grassroots Public Engagement

We need Canadians to continue to support the National Pain Strategy! One in five Canadians is affected by chronic pain. They and their families can be powerful advocates for our cause.  For this reason, we need to encourage members of the public to support the need for a National Pain Strategy and continue to engage their local elected officials on the issue.

Stakeholder Integration

Our partner and supporting organizations all have an interest in minimizing suffering and raising awareness of the physical and psychological effects of pain.  We have a solid foundation of one hundred and fifty eight organizations that have endorsed the National Pain Strategy to date.  Many of these organizations have thousands of members.  Recognizing that there is strength in numbers, we must combine our resources to collaborate on issues of mutual concern.

Please Help!

We need to move forward on behalf of all Canadians (and their families) affected by pain.  To continue our efforts, we need your support!  If you care about better management of pain in Canada stay engaged and tell your family and friends about the National Pain Strategy.  Go to the website and join our mailing list and consider donating to the initiative (www.canadianpainsummit2012.ca), Contact us at nps@dal.ca if you'd like to become more involved!

 

Summit Presented By

CANADIAN PAIN SUMMIT MISSION:

Working together to improve the treatment of pain for all Canadians.

 

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REPORTS & BRIEFS

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Liberal Health Critic Supports a National Pain Strategy

To read Federal Liberal health critic Dr. Hedy Fry's message to the National Pain Strategy
click here.

 

Letter to the Editor - The Ottawa Citizen

A Perfect Storm is Brewing

Dear Editors:

Sharon Kirkey’s article “Oxycontin’s removal could cause a whole new set of problems” published yesterday, underlines the dynamics that are leading inevitably to a perfect storm.  On the one hand, we have an ongoing problem with drug addiction and on the other hand, we have a problem with massive ignorance about the appropriate treatment of pain.

 

Kirkey quotes experts who have indicated restricting access is not going to put a dent in the problem of abuse and addicts will simply switch to something else. It is also pointed out that Doctors are not being taught enough about prescribing opioids in the proper places.

 

This is true, for people doctors that is. Veterinarians get five times more training in pain management than people doctors.  Canadians are not receiving adequate access to treatment for acute, chronic (including arthritis) or cancer pain and this is leading to a growing epidemic.

It is time to support a national strategy for pain.  For further information, go to:  www.canadianpainsummit2012.ca.

Sincerely,

Dr. Mary Lynch, Co-Chair

Canadian Pain Summit

-and-

Past President

Canadian Pain Society

 

Pain in Canada Fact Sheet

Presented by the Canadian Pain Society (CPS) and the Canadian Pain Coaltion (CPC)
Pain is poorly managed in Canada

  • Although we have the knowledge and technology, Canadians are left in pain after surgery, even in our top hospitals.
  • Only 30% of ordered medication is given, 50% of patients are left in moderate to severe pain after surgery and the situation is not improving (Watt‐Watson, Stevens et al. 2004; Watt‐Watson, Choiniere et al. 2010).
  • Growing evidence has identified that many common surgical procedures cause persistent post‐operative pain that becomes chronic (Kehlet, Jensen et al. 2006).
  • Pain is the most common reason for seeking health care and as a presenting complaint accounts for up to 78% of visits to the emergency department, recent research continues to document high pain intensity and suboptimal pain management in a large multicenter emergency department network in Canada and the United States (Todd, Ducharme et al. 2007).
  • Uncontrolled pain compromises immune function, promotes tumor growth and compromises healing with increased morbidity and mortality following surgery (Liebeskind 1991).
  • One in five Canadian adults suffer from chronic pain (Moulin, Clark et al. 2002; Schopflocher, Jovey et al. 2011) children are not spared with 15‐30% of children experiencing recurring or chronic pain (Stanford, Chambers et al. 2008) and the prevalence increases with age (Hadjistavropoulos, Gibson et al. 2010).
  • Many cancer and HIV survivors have greater quantity of life but unfortunately a poor quality of life due to chronic pain conditions caused by the disease or the treatments that cause irreversible damage to nerves (Levy, Chwistek et al. 2008; Phillips, Cherry et al. 2010).
  • Chronic pain is associated with the worst quality of life as compared with other chronic diseases such as chronic lung or heart disease (Choiniere, Dion et al. 2010).
  • Based on US figures documenting that the cost of chronic pain in adults including health care expenses and lost productivity is $560‐$630 Billion annually it is estimated that the annual cost of chronic pain in Canada is at least $56‐60 Billion dollars (Relieving Pain in America - 2011).
  • People living with pain have double the risk of suicide as compared with people without chronic pain (Tang and Crane 2006).
  • A recent review of opioid (narcotic) related deaths in Ontario, identified the tragic fact that pain medication related deaths in Ontario are increasing and that most of the people who died had been seen by a physician within 9‐11 days prior to death (emergency room visits and office visits respectively) and the final encounter with the physician involved a mental health or pain related diagnosis. In almost a quarter of the cases the coroner had determined that the manner of death was suicide (Dhalla, Mamdani et al. 2009).
  • Veterinarian students receive three times more pain education than human health professionals and five times more hours than medical students (Watt-Watson, McGillion et al. 2009).
  • Pain research is grossly under‐funded in Canada (Lynch, Schopflocher et al. 2009).

BC Pain Summit - an amazing success!

Pain BC hosted the Provincial Pain Summit, June 2 to 4, 2011 - the first event of its kind in the province.  The Summit was an amazing success, attracting a mix of health care providers, administrators, patients and their families, researchers, as well as members of the non-profit and corporate sectors.  Several media outlets covered the event, raising awareness of chronic pain, sharing the stories of patients and providers, and highlighting some of the initiatives underway to reduce the burden of pain in British Columbia.

 

The Summit’s dialogue-based format was welcomed by all, providing rich opportunities for expertise to be shared, barriers to be identified, and recommendations for change to be generated.   A summary of the Summit and presentations from all sessions are now posted on the Pain BC website.

 

The Summit Final Report outlines Pain BC’s future directions and they are already working on implementation plans for several of the recommendations.  Progress will be reported in future newsletters Pain BC newsletters.

 

Sincere congratulations are extended to Pain BC from the Canadian Pain Summit 2012 Executive Committee.  We look forward to working with you and others across the country to improve the treatment of pain for all Canadians!

EDITORIAL

by Dr. Mary E Lynch, MD FRCP, Past President - Canadian Pain Society
Excerpt from Pain Research & Management - March/April 2011 - Volume 16, Issue 12

The Need for a Canadian Pain Strategy

Pain is poorly managed in Canada.  This includes acute pain caused by ongoing tissue damage, trauma or surgery, chronic pain and pain related to illness.  Reasons for this include under-recognition of the problem, lack of education in pain assessment and treatment in graduating health care professionals, and gr0ssly inadequate funding for research regarding pain.  Although we have the knowledge and technology, Canadians cannot be sure they will receive adequate or appropriate treatment for pain along the entire continuum of care from community health professionals to specialists in tertiary health care institutions

 

Brief to Parliamentary Committee on Palliative & Compassionate Care

CLICK ON the title to obtain a copy of this important Brief submitted to the Federal Government - October 19, 2010


Dr. Mary Lynch, Past President of the Canadian Pain Society (CPS) and Co-Chair of the Canadian Pain Summit 2012, along with Lynn Cooper, President of the Canadian Pain Coalition (CPC), made presentations last fall to the Federal Standing Committee on Palliative and Compassionate Care.  The tri-party Committee Co-Chairs are:  Harold Albrecht, MP for Kitchener-Conestoga; Michelle Simson, MP for Scarborough Southwest; and Joe Comartin, MP for Windsor-Tecumseh.

 

Pain Control

"People in pain have a right to fully adequate pain relief treatment.  Indeed, for the healthcare professional to act unreasonably in leaving a person in pain is a breach of a fundamental human right of the person.  Physicians should not fear that giving adequate pain relief treatment is unethical or illegal; in fact, they should fear the ethical and legal consequences of not doing so."

Dr. Margaret Somerville, Director of the McGill Centre for Medicine Ethics and Law; Samuel Gale Professor of Law

Excerpt from Dr. Somerville's submission:  The Case Against Including Euthanasia and Physician-Assisted Suicide as Part of Palliative and Compassionate Care.  Presented to the Standing Committee on Palliative and Compassionate Care, Montreal, QC - July 20, 2010