Letter to the Editor

Re: December Cover Story: Rethinking opioid use

My name is Chris Cull and I am in long-term recovery after a seven-year #opioid addiction and dependency.

Unlike and not unlike a lot of Canadians, I didn’t start down the path of opioid abuse through a prescription. When I was 22 years old, my father, after a roughly six-year battle with Huntington’s Disease, succeeded in taking his own life. The result of that incident was pure devastation. In retrospect, I was not maturely nor emotionally developed enough at the time to manage the loss productively, so I turned to Percocets which I got off the streets to try and numb out my pain.

That then escalated into using five 80mg Oxycontins a day, over a two year span that that eventually saw me lose my house, my girlfriend and over six figures in cash. I decided to enter a harm reduction program, which took five years from beginning to end, to beat my opioid dependency. Finally free from addiction, I set the biggest challenge for myself I could think of: To ride my bicycle across Canada and film a documentary with the goal of bringing awareness around this growing health concern and show how prevalent the prescription drug crisis has become. What I found was troubling to say the least.

I stopped and walked around in every town I passed through to talk to the local community about prescription drug abuse. The phrase I heard most often was, ‘You’ll find a lot of that around here.’ And when you start to hear that in every city, in every province, across the entire country, it begins to raise questions as to why this is occurring and what can we do about it.

I was given the opportunity to interview many people across the country who have been affected by the prescription drug abuse epidemic; abuse commonly began through legitimate dosage of prescribed #opioids for pain and, of course, recreational use.

Some of the stories I encountered include an 18-year-old girl from Regina, Saskatchewan, who developed a physical dependency in high school at the age of 16 after being prescribed Oxycontin due to a hairline fracture in her pinky finger. Another unforgettable story I encountered was that of an elderly woman in Northern Ontario who was prescribed opioids for chronic pain, who eventually became physically dependent, then began doctor shopping so she could sell her prescriptions to supplement her income as well as feed her addiction.

Stories like these exist everywhere across the country and with an estimated 432,000 Canadians currently dependent on either heroin and/or opioid painkillers, the time has come where we need to at minimum mitigate this problem.

How to do that with such a complex problem to solve is difficult; there are so many different variables and dynamics that play into it. I am not a doctor nor a medical professional of any kind, but after studying the broad scale of the problem and looking at it objectively, I have a few thoughts, using sensible logic, as what to work on.

I believe that awareness, education, prevention and treatment working collectively with medical professionals, academics, government, and the general public is where we can improve.

The first step to solving any problem is recognizing there is one, which is where awareness comes into play. As a person who has felt the stigma associated with being addicted to and dependent on prescription painkillers, I understand how difficult it can be to seek help. But I encourage everyone who has been touched by this crisis to speak out and share their stories so we can make it easier for those in the future to seek help without the overwhelming feeling of shame.

By doing so, we shine a spotlight on the crisis and show how prevalent it is.

Education on opioids is the most important factor in this entire equation as it plays a vital role in both prevention and treatment. Both the physician and patient need to have a clear understanding of the potential for harm that comes with prescribing opioids. This is particularly important with chronic pain where sustained opioid use develops into a quick tolerance to the drug, leading to higher dosages and/or physical dependency.

If all parties involved are educated on the potential for harm with opioids and even being educated on non-drug therapies for certain pain states, then the potential for prevention is much higher.

The one aspect I found in my travels that is severely lacking is adequate resources for treatment, especially in rural areas. Whether it be harm reduction, counselling or meetings, the lack of resources pertaining to opioids in specific areas is appalling. One way to help improve access to treatment would be to encourage and support rural GPs to play a role in their communities by offering treatment for opioid dependence. If we can give everyone the tools they require to fix the problem, we can significantly lower the alarming statistics.

With the right support and resources, people suffering from opioid dependence can move on from addiction and live in recovery. One amazing resource I am proud to align myself with in my personal mission to help provide Canadians with access to the opioid addiction services they many need is ORbeOK.ca. The site is one of the first and most comprehensive websites for Canadians suffering from opioid dependency. ORbeOK.ca offers educational resources on what opioid dependence is, how to recognize if you or someone you love is becoming dependent, community news as well as where to go to get the medical and emotional help you need.

That being said, I understand everything involving the opioid epidemic is much easier said than done and it will take time. But I am confident it can be done.

This is by no means a “how to” note as there are many more pieces to the puzzle than I have highlighted — it is simply a call to action. As mentioned, there are so many different variables to the equation and it is not a black and white issue.

Understanding that, we need to find a balance within the spectrum of everything the opioid epidemic entails and take a new approach to it. If we all do our part — whether it is physicians, pharmacists, academics, government, industry or the general public — we all have our own part to play in this and if we can change it now, we can look forward to a brighter future tomorrow.