Ontario recently move to become the first Canadian jurisdiction to eliminate high-dosage opioid medications from its drug plan. Photo/Courtesy of Magic Madzik via Flickr [http://bit.ly/2aSGzal]

Relieving pain

By 
  • August 4, 2016

Widespread abuse of prescription painkillers is a major problem that governments are right to address. But Ontario’s recent move to become the first Canadian jurisdiction to eliminate high-dosage opioid medications from its provincial drug plan goes a step too far.

Few would question efforts to discourage overuse of powerful drugs such as fentanyl, demerol and morphine. There is little doubt that strong painkillers are too common in household medicine cupboards. Even when prescribed by doctors to manage serious chronic pain, these drugs can be addictive and sometimes lethal when used legally.  When sold illegally into the black market, they leave an even longer trail of harm.

But these same powerful drugs are often fundamental components of effective palliative care. Patients near the end of life and in extreme pain due to cancer or some other disease often require potent opioids to ease suffering in their final days. To start denying many of them subsidized access to this essential pain relief is beyond wrong. It’s cruel.

The timing of Ontario’s new policy, effective in January, is particularly vexing. It follows the Supreme Court ruling and subsequent federal legislation that made assisted suicide and euthanasia legal in Canada. The primary argument by proponents of state-sanctioned killing is that it offers a merciful end to people who are suffering. For Ontario to now propose regulations that would deny the mercy of comprehensive care to people seeking a natural death is callous.

Limiting pain medication will inevitably cause some sufferers to reject palliative care in favour of an immediate assisted death. They’ll choose death over suffering. Mostly these will be society’s have-nots. Ontario’s subsidized drug plan typically serves seniors, the disabled and those on social assistance, people who tend to have little money and no health insurance. The new opioid regulations threaten to cut them off while those with money retain access to these high-dosage painkillers.

Opponents of doctor-assisted killing have worried that, as society ages and health costs soar, euthanasia could become a savings tool for cash-strapped governments. There is no indication that Ontario’s political leaders are that cynical. Yet eyebrows will be raised at the timing of this announcement. Either way, the prospect that some people may feel financial pressure to accept a lethal injection is morally offensive.

Governments have a duty to provide comprehensive and affordable palliative care. It is unconscionable that someone may be offered a fully paid drug cocktail to end their lives but be denied subsidized pain medication to make their final days tolerable. Yet that is what these new regulations threaten.

Thankfully, there’s time to fix the problem. Palliative pain medications should be exempted from any opioid crackdown. Surely, people at the end of life deserve as much.

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