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This time, the war on drugs has become a war on pain patients. How about a war on pain for a change? Taking stable pain patients off opiate analgesics or reducing them to doses too low to work has caused them pointless suffering and even death — by suicide, or by overdosing on the street drugs they’re forced to buy to top up the small bit of legal analgesia they’re now allowed. For doctors, it’s led to “a climate of fear” around prescribing. In November, three Ontario physicians published an open letter in the Canadian Medical Association Journal confirming all this and saying it has to stop. I know doctors who cheered. Is anyone really surprised?

While doctors are indeed prescribing less, Alberta’s opiate overdoses are still going up — from 2016 to 2017 by a whopping 40 per cent. The trend is Canada-wide: less prescribing, more overdose deaths. That’s because prescribing is one thing and street-dealing quite another. Canada’s doctors haven’t contributed to street deaths. Patients haven’t been doctor-shopping, nor have they been faking pain to get prescriptions or selling their medications to dealers and addicts.

Prescribed drugs rarely make it to the streets. The single study we have on Canadian “diversion” rates, from 2012, says data is too “fragmented, unsystematic, and insufficient” to inform evidence-based policy. (A 2015 update says more of the same.)

But there is a lot of recent evidence that medical use doesn’t cause addiction. An analysis of 17 studies involving 88,235 patients and published in the medical journal Addiction concludes there’s little risk of addiction for people using opiates for pain. A study from the Journal of the American Medical Association cited last May in the Canadian Journal of Pain found that of 39,140 Ontario surgical patients, only 0.4 per cent were on an opiate a year after surgery, and then likely for ongoing pain.