Still grieving the loss of her brother who committed suicide in October, local resident Carol Sabo is challenging the College of Physicians and Surgeons of B.C. to require doctors to prepare a more comprehensive treatment plan when they wean people off medications.
Leonard Sabo, 58, was on medication for chronic pain and Carol says he took his own life Oct. 20, driven by pain and fear of increased misery because his medication was being decreased.
He wrote a blunt note just before he took his own life, and this is a slightly edited version:
“I just can’t put up with the pain no longer. My foot will not let up,” he wrote. “I can’t imagine going on any longer after being on morphine for 15 or 20 years.
“Can’t even sleep. It hurts too fricken’ much and since doctor (name removed) cold-turkeyed me on antidepressants and I got mad, no other one will take me seriously.
“I realize that everybody’s going to say I’m just a dead junkie but it was doctors that got me so wired on them. It’s just not right.
“Tell the person that finds me I’m sorry if I caused him grief but I’m going nuts just rolling around in pain every night for the last two months, plus now my back is acting up again.”
Carol Sabo says her brother is not the only one in such a situation, and others are also having medications decreased.
Doctors are following strict regulations meant to limit the amount of pain medication being prescribed, regulations that were released in June by the doctors college. The move follows research suggesting that the effect of opioids, which are synthetic and non-synthetic medications such as morphine, codeine, hydromorphone and fentanyl, may be limited in their affect for long-term treatment of chronic non-cancer pain.
Also, climbing with increasing numbers of prescriptions is medication misuse, numbers of people in B.C. with opioid dependence and addiction, as well as deaths involving these drugs.
B.C. dispenses more than double the amount of opioids compared to Quebec and the dispensing rate in B.C. increased by almost 50 per cent from 2005 to 2011.
While Sabo agrees wholeheartedly that this issue needs to be addressed, and that the move to decrease prescriptions is a good one she says it is not enough for doctors to simply wean people off of high amounts of medication. She does not blame the doctor or college for her brother’s suicide but hopes it will stimulate more caution.
“I do not believe that the college was my brother’s keeper, but I do believe there should be a better plan than ‘let’s lessen the amount of opiates prescribed,’” Sabo wrote to the college.
She says there needs to be a support plan in place to help people work through withdrawal as they overcome addictions, whether to legal or illegal drugs.
Detox centres can take people through the physical worst part of withdrawal but Sabo, who spent years at the Ksan House Society as its executive director, says a longer-term follow up is needed for people to rebuild their lives. Her brother Leonard went to a detox many years ago and returned home clean, she said, but he very quickly fell back into his addictions because there were not enough supports.
“For somebody to try and get off any kind of addiction, you need to change your lifestyle and your friends and all that stuff, and you need to keep busy,” she said. “That’s the big thing, because if you have nothing to do, then you’ll want to go back to the same old.”
She says supports in Terrace are limited and a local place is needed so that people overcoming addictions can “immerse themselves in a variety of programming, with hands-on stuff to keep them busy.”
Sabo also said that as the college responds to growing pressure to reduce overprescribing, it has not fully considered the people who are in pain and struggling under decreased medication.
“The college needs to pay attention to the people who are being affected, and I don’t believe they are,” she said.
Ultimately, Sabo says the medical system needs to start working with other agencies. People with addictions are often in situations that can lead to death, and their safety must trump confidentiality, she said, noting that police and schools are realizing this as well.
“It’s life or death for the people who are addicted,” Sabo said, adding that doctors should connect with pharmacies to prevent addictions. As they follow these new regulations to limit prescriptions, they should network with social services to help those coming off addictions.
“If doctors are the ones instituting this change, they should be the ones to call that inter-agency meeting about a certain client,” she said.