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Lesley Jansen

Pain is not just an issue for seniors it is an issue for people of all ages/backgrounds, and physical pain can and will most likely lead to mental health issues if the cause of pain is left untreated. The form of treatment can lead to complications, such as the use (legal) and misuse (illegal) of drugs as was the case of the over prescription of oxycodone and the resulting opioid epidemic in both Canada and the United States.

The Canadian Institute for Health Information (2019) stated: “Pain is one of the most common reasons for Canadians to seek health care, with 1 out of every 5 adults in Canada experiencing chronic pain.” That: “1. Prescription opioids, such as codeine, oxycodone and hydromorphone, are commonly used for treating pain. 2. Other reasons opioids may be prescribed include treating cough or opioid dependence. 3. Opioids, when prescribed and used appropriately, are effective drugs that play an important role in pain management for many Canadians. However, opioids can also produce a feeling of euphoria or a “high” and sometimes opioid use can lead to harms, including addiction, poisoning and death. In 2018, almost one in eight people were prescribed opioids. From January 2016 to June 2018, more than 9,000 Canadians died from apparent opioid-related harms.”

In the United States, a documentary aired by PBS titled “Understanding the Opioid Epidemic” was produced on 17 January 2018, and was shown on TV and YouTube. It was found that part of the problem with the U.S. opioid epidemic was that U.S. doctors were over-prescribing opioids such as OxyContin (brand name for oxycodone) for individuals suffering in pain (for example, due to accidents, etc.). It was also found that some of these individuals had moved on from using legal drugs such as OxyContin to illicit street drugs such as fentanyl and heroin as they were cheaper. Doctors/researchers found a connection between alcohol and marijuana (cannabis) and the use of opioids (i.e., moving on from those two substances to illicit street drug opioids, such as fentanyl and heroin). The doctors stated that addiction is permanent and life-long (to end of life). Once addicted, the person is like, for example, a diabetic, and that there is no cure. The affected individual will need to learn coping skills through (and) treatment for the addiction and, as well the pain.”

In order to explain pain and pain disorders, medications for pain treatment and coping skills for living with pain, a book was written by three doctors (Vladimir Maletic, MD, Rakesh Jain, MD, MPH, and Charles L. Raison, MD) (2012). The book was named “100 Questions & Answers About Chronic Pain.” This book explains: “Chronic pain sufferers can find themselves having three problems: fatigue, trouble sleeping, and memory difficulties. There is a bidirectional relationship between pain and sleep. Individuals with chronic pain conditions tend not to sleep very well. Sleep deprivation, in turn, intensifies pain. Both sleep disorders and chronic pain have been associated with a decrease in hippocampus gray matter volume. The hippocampus is a brain structure that plays a key role in emotional regulation and stress responses, but also in spatial and declarative memory (i.e., being able to find the right word and remember names). Evidence suggests that sleep deprivation, much like chronic pain, may increase inflammation. Inflammatory cytokines tend to be elevated in patients with sleep disturbances or with chronic pain. Chronic fatigue patients have Chronic Fatigue Syndrome (CFS) a condition which is characterized by a sensation of exhaustion and inability to carry out physical and intellectual tasks. Over time, many CFS patients will suffer from headaches, migratory joint pain, generalized muscle aches, sore throat and chest pain. Patients with CFS typically suffer from a number of other related conditions, including fibromyalgia and mood and anxiety disorders.” 

In the Legion Magazine January/February 2021 – the article (by Sharon Adams): “Pain Centre: A New Centre of Excellence – A Network of Clinics, Researchers and Patients – Aims to Find Chronic Pain Relief for More Veterans – stated that: “Many CAF (Canadian Armed Forces) veterans live with chronic pain. More than 40 per cent of veterans who left the military since 1998 have chronic pain – two to three times the rate of civilians.” It was found that “millions of Canadians struggle with chronic pain, but it is not fully understood how it develops or how best to treat it.” And that “the total economic hit is estimated at up to $60 billion annually.” “The Chronic Pain Centre of Excellence for Canadian Veterans, based at McMaster University in Hamilton, Ont., hopes to end the trial-and-error approach by identifying effective evidence-based treatments, recommending standards of care, and sharing that information so it can be rapidly put to use treating veterans. We spend a lot of money on diabetes, heart disease, cholesterol, cancer – but chronic pain research has been underfunded.” 

The research happening at McMaster University will benefit Canadians of all ages coping with physical pain and mental health issues. Any use and misuse of drugs will have an impact on the quality of life for individuals and their families, and the community. More research needs to be done and proper treatment methods must be implemented to save lives from the risks and dangers associated with opioid use. We need to limit and end the stress being placed on our health care system through proper treatment so that those needing timely access to mental health care will have access when they need it most.”

Lesley Jansen is a senior and a life-long learner attending the Faculty of Arts, Psychology, at the University of Manitoba. She is interested in issues on chronic pain as she is an Army veteran living with a disability.

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