Pain Is Good (Until It's Not)
Education and Advocacy Janet Yale discusses pain management in Canada and urges a commitment to patient access.
ain is good. Pain is our body sending a signal to our brain to tell us to pull our hand away from the hot stove or to favour a sprained ankle. It is our early warning system, helping protect us from further harm. Remove the stimulus and the pain signal goes away. Sometimes, something goes wrong. Whether it’s because the source of the pain is still there, or because the pathways in the brain that interpret pain get stuck in the on position, the pain signals don’t go away. They keep coming, becoming a flood that rises and falls but never entirely leaves. Pain becomes your constant companion, and it colours everything you do.
The impact of pain
This is life with chronic pain, and it is the daily reality for far too many people, including over 4.6-million Canadians living with arthritis. Despite the advances made in identifying and managing some forms of arthritis over the past 20 years, there is still no cure. That means too many people still live with the devastating impact of arthritis symptoms, such as inflammation, restricted mobility, fatigue — and pain. Especially pain.
Chronic pain erodes your quality of life, your ability to be fully productive at work or to enjoy time at home or at play. And because the disease symptoms are often invisible, it’s very difficult for the people in your life to understand why you can’t balance work and home life or have leftover energy for friends or exercise. It should come as no surprise, that a person living in chronic pain is three times more likely to experience depression or mental health issues.
Yet our health care system is poorly designed to meet the needs of people with chronic disease. And, acknowledging pain remains taboo.
Hope for today
The Arthritis Society and other organizations continue to invest in research that will ultimately deliver a cure for arthritis, and erase the pain once and for all. In fact, this September — thanks to the generosity of our donors — we marked Arthritis Awareness Month by announcing nearly $5 million in new research commitments.
There’s still a long way to go. While investments offer hope for the future, it is equally important we address the very real needs of people who are living in pain today.
That is what brought me before the federal government’s Task Force on the Legalization and Regulation of Marijuana late last month. Together with representatives from Canadians for Fair Access to Medical Marijuana and the Canadian AIDS Society (along with other signatories), we asked the government to remember the needs of the thousands of Canadians who are already taking cannabis for medical purposes — including arthritis pain — and the many thousands more who might also benefit from it.
Commitment to patient access
With increased legal access to medical cannabis, many Canadians have a new option for pain management. Common pain relievers such as acetaminophen, ibuprofen, or naproxen may be ineffective or contraindicated, and for obvious reasons. More potent narcotics are rarely suitable for the prolonged use required in the case of chronic pain. Medical cannabis may offer these patients a reasonable alternative to help alleviate the most pressing symptom of their disease.
But, increased access does not yet mean equitable access, so we challenged the Task Force to address Canadians’ needs around medical cannabis in three areas:
- Accessibility: Canadians must have reliable access to medical cannabis that is well regulated for safety, potency, and quality. Also, patients and physicians must be educated about how to access the drug, as well as its appropriate use.
- Affordability: Medical cannabis must be treated like any other medical necessity: like other drugs, it must be exempt from all sales tax, and its costs must be eligible for coverage from public and private health insurance plans.
- Support for Research: The federal government must actively expand the evidence base on the medical use of cannabis through enhanced support and promotion of medical cannabis research, and must use additional policy levers at its disposal to help support and promote that research.
The Arthritis Society announced earlier this year we are doubling our own commitment to medical cannabis research to $720,000 by 2020. However, in order to mobilize the scale of research that is required, we need help. That is why we and other stakeholders have called on the federal government to step up with an investment of at least $25 million over the next five years to fund medical cannabis research and clinical trials.
As a nation, we can no longer turn away from the needs of our neighbours, colleagues, and loved ones who struggle with the burden of chronic pain. It’s time to take pain seriously.