July 21st, 2018

People using opioids for chronic pain stigmatized


By Lethbridge Herald on April 11, 2018.

Local advocate Jennifer Kremenik worries legitimate opioid users who need the drugs for pain management could be affected by efforts to police the drug. Herald photo by Ian Martens @IMartensHerald

J.W. Schnarr
Lethbridge Herald
jwschnarr@lethbridgeherald.com
Efforts to limit access to opioids through prescriptions could cause undue hardships for people dealing with chronic pain, says a local advocate.
As well, there are many dealing with chronic pain who feel they are dealing with a stigma attached to their medication.
Jennifer Kremenik said she worries that in the rush to get opioids out of the hands of illicit users and addicts, legitimate users who need the drugs for pain management could be affected by efforts to police the drug.
“I’ve been on OxyNEO for 12 years on the same dose,” she said. “It makes me angry to be labelled as something or accused of something just because I am on a medication.”
Kremenik isn’t alone. She runs an online support group for people who suffer from Ehlers-Danlos syndrome which she also has. She said she has heard from other people who have been accused of doctor shopping, double doctoring and other behaviours often associated with people suffering from opioid addiction.
“Thank God we have good advocates for the issues,” she said.
Kremenik was an active child who kept busy taking part in sports such as gymnastics and figure skating.
“I was really good at any sports or activities that require you to flex or stretch,” she said.
But when she was in junior high, she started experiencing soreness in her joints. She started waking up stiff and it was felt at the time she might have been over-exerting herself. She scaled back on her activities, but then she began having mobility issues.
In Grade 11, the dislocations began.
“My joints would pop out,” Kremenik said. “They would half go in and out. It was quite painful.”
And so began a long journey through the medical system searching for answers.
She was told the dislocations were a normal part of growth at her age. And she continued to hear that she was overdoing things.
“I had to stop doing any activities, other than normal day-to-day things,” Kremenik said.
Instead of sports, a long line of specialists took up her time — more than 60 specialists from the time she finished high school to the end of university.
Eventually, a doctor found the source of Kremenik’s dislocations and her constant pain. She was diagnosed with Ehlers-Danlos syndrome, hypermobility type. The genetic disorder is characterized by hypermobile joints, spontaneous dislocations and debilitating chronic pain.
To date, Kremenik has had 37 surgeries; mostly on her knees and her shoulders, but also her jaw and hips.
As the pain increased, so has her use of painkillers.
“Today, I’m on the dreaded OxyNEO,” she said, referring to the brand name for oxycodone controlled-release medication. “As soon as anybody hears you are on OxyNEO, or oxycodone, you are automatically labelled.”
The College of Physicians and Surgeons has highlighted an effort in the medical system to provide fewer opioid prescriptions.
According to the group’s data, in the 12 months between September 2016 and 2017, the number of Alberta residents prescribed any of the five main opioid painkillers dropped by seven per cent, or around 9,000 from 127,000 to 118,000 in any given month. The reduction is mostly in codeine users.
The total volume of these drugs prescribed dropped by 14 per cent measured in “oral morphine equivalents.”
Kremenik says it can already be difficult for chronic pain patients to secure doctors willing to treat them. She believes there may be a level of stigma involved.
“It is my hope we can change that stigma,” she said. “Just because people are on pain meds doesn’t mean they can’t function.”
On a personal level, she worries about potential difficulties that could arise if anything ever happens with her current doctor.
“My doctor gives me prescriptions monthly,” she said. “Other patients get daily or weekly releases. I’m lucky to have a good doctor who knows me, trusts me, and understands my medical condition.”
Follow @JWSchnarrHerald on Twitter

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