Lengthy wait times for proper pain treatment can drive many suffering Canadians to self-medicate

From the Toronto Star

Stephen Yeates has lived an odyssey of pain. Over the past eight years the 53-year-old family man has deteriorated from a robust director and cinematographer for TV commercials to someone who can leave his home for only a few hours at a time.

Suffering from the fallout of degenerative disc disease, he hasn't worked for four years. His search for relief has taken him to Buffalo for an MRI and to Germany for a $50,000 back operation that gave him two artificial discs.

And when the bank-breaking surgery offered no relief, he kept searching.

Now, after trying many different drugs (becoming addicted in the process) and therapies, plus self-medication, he's on a waiting list to have a device implanted in his spinal cord, a last try at easing his pain. It's not the first time he's had to wait for treatment. "I recall asking for an appointment at the London Health Sciences Centre in October 2004, and they said they could see me in November. I was thrilled. But they meant November 2005," he says.

His story of delays in getting treatment and failed attempts at alleviating his suffering is a familiar one in this country, pain experts say. "Wait times for treatment at pain facilities are too long," says Dr. Mary Lynch, president-elect of the Canadian Pain Society. And she says that with longer wait times, patients can go downhill quickly. Chronic pain left untreated gets worse. The Dalhousie University professor is shocked that so many Canadians are left to suffer.

Lynch says there are two major contributing factors:
Not enough treatment facilities in Canada, which lengthens wait times.
And health care practitioners who are not adequately trained in pain management techniques.
Yeates says, "I spent years trying to find out what was wrong. I saw lots of different doctors and every new appointment started with a set of X-rays."

He's visited physiotherapists, chiropractors and acupuncturists. "I've tried nerve blocks but they weren't effective," he says. "I lost weight, hoping that would help."

In the very beginning he relied on Tylenol and, he admits, alcohol, though he has since stopped drinking.

And there were drugs. He took OxyContin for two years but became addicted.
"You have to be very disciplined. You have the pills in your hand and you want to take more. I consider myself a balanced person. I stuck to the allowed dosage."

Earlier this year he tried Sativex, a cannabinoid that's sprayed into the mouth. "But it didn't work for me," he says. Yeates credits his wife of 20 years and his two teenaged children for getting him through the agony of the past few years.

Now being treated at Mount Sinai Hospital's Wasser Pain Management Centre, Yeates is off OxyContin and on a combination of methadone and Lyrica (marketed to treat nerve pain caused by diabetes or shingles) and Tylenol.

"My only hope is to get on a list for a spinal cord stimulator," he says, "But that will take time."
The wireless electrical device is implanted and operates by remote control, Yeates explains. "There are leads attached to the nerves on the spine which can block the pain signal.
"This is a way to get me off the drugs," he says.