April 24, 2017
Chronic Pain Cover Photo

The Physiotherapy Association of British Columbia's fifth position paper in advance of the provincial general election scheduled for May 9 is entitled BC's Opioid Crisis: How Physio Can Help with non-pharmacological management of pain. The paper is in response to the soaring number of drug deaths in the province in recent years.
One year ago, in April 2016, the Provincial Health Officer declared a public health emergency in response to an explosion in deaths due to drug overdoses. Between 2007 and 2016, the number of drug deaths in British Columbia rose from 202 to 922.

This new position paper attempts to provide a fresh perspective on this vital challenge. The PABC has tried to look at the larger issues of chronic pain, the consumption by Canadians of prescribed pharmaceuticals to address pain and other health problems, and the misuse and abuse of these prescription drugs.

Among the points addressed in the position paper:

  • Approximately 20 per cent of all British Columbians suffer from chronic pain. That number is much higher for seniors – and notably for elderly women.
  • Canada, on a per capita basis, is the world’s second largest consumer of opioids. Specifically, our country is the largest per capita consumer of hydromorphone; the second largest for oxycodone; third for morphine; fourth for fentanyl; and the seventh largest of methadone.
  • Chronic pain produces complex changes in the nervous system. Prescription opioids, often used to provide relief from chronic pain, contain substances which may induce a sense of euphoria. Unfortunately, there is a risk they will be abused or misused – indeed, Health Canada reports that 6.3 per cent of adult Canadians who were prescribed a psychoactive pharmaceutical admit they had abused their prescription.
  • Seniors are especially susceptible to drug abuse or misuse because many are over prescribed. As many as one-quarter of Canadian's aged 65 years and older concurrently take 10 or more prescribed drugs, and two out of three are taking five or more.
  • In British Columbia in 2016, total expenditures on drugs, by both the public and private sectors, was calculated at $3.8 billion.

The paper examines the growth of both drug use and drug costs in BC over recent decades, and suggests that physiotherapy can be a cost-effective, non-pharmaceutical adjunct to prescribed opioids.

It is important, therefore, that physiotherapists receive consideration from provincial policy makers and health administrators as the province wrestles with a number of challenging issues, including: the worrisome increase in prescription drug use/abuse, rising illicit drug overdoses, and the ever-rising cost of prescription drugs.

Media Coverage

B.C. physiotherapists say they can help alleviate the opioid crisis. CBC News Online, April 25, 2017

Physiotherapy could help combat B.C.’s opioid crisis: report. Parksville Qualicum Beach News & Trail Times, Ashley Wadhwani, Apr 25, 2017

B.C. physiotherapists say they can help alleviate the opioid crisis. CityTV News/Breakfast Television (Scroll to 4:28), Apr 25, 2017