'My only other option is to die': N.S. woman dismayed by pain clinic closure
Published Friday, November 10, 2017 2:25PM AST
Last Updated Friday, November 10, 2017 6:40PM AST
A Nova Scotia woman says if the Dartmouth Pain Clinic closes, she will be left with two options: seek her medication illegally on the streets, or end her own life.
Dawn Rae Downton has been living with chronic pain due to sacroiliitis, a form of inflammatory arthritis, for more than two decades and has been a patient at the Dartmouth Pain Clinic for nearly 10 years. On Thursday, a message on the answering machine at the clinic told patients it would be closing for good on Dec. 31.
“I had a very good pain physician there. He knew how to treat me, he knew that it was appropriate to treat me with fentanyl,” she said.
She says her physician at the pain clinic told her in July that he would be retiring in another three to four years, so it was a shock to hear in October that he planned to close his practice at the end of this year.
“Since then, I’ve looked for anyone – a (general practitioner) who will prescribe, another pain specialist. I’ve looked through Nova Scotia, I’ve looked across the country, I’ve looked into the United States,” she said.
Despite her search she has not been able to find help. Her family physician dropped her as a patient this year, and Downton says it’s because she is an opioid patient.
“My only options are now to go to the street to a street dealer. Not sure if I can afford that, not sure if I will get what I’m hoping to get, rather than something deadly. My only other option is to die,” she said. “And that’s a good option, because if I went back to the kind of pain that I had before I was seen by a pain clinic and put on fentanyl, I just couldn’t tolerate it. It would be pointless to go back to that kind of life.”
“I was unable to stand, to walk, to sit, to lie down and especially not to sleep, there was so much pain involved,” she said.
Downton says she waited nearly four years to get into a pain clinic. Doctors tried to treat her pain with non-medicinal therapies, including acupuncture, mindfulness, and physiotherapy. She says she also tested a number of pharmaceutical options, but nothing worked. As a last resort, she was put on fentanyl patches.
“And they gave me back my life,” she said. “So to be facing a situation now where I don’t have adequate pain meds leaves me with an intolerable life.”
The Nova Scotia Health Authority says a new pain specialist will start working in a private practice in Dartmouth in January. Another specialist is being recruited. It’s not clear how many of the Dartmouth Pain Clinic patients they will take on. In fact, the NSHA is unable to say how many patients the clinic has.
“We are doing our utmost and we are going to try to increase our capacity so we can look after these patients,” said Dr. Romesh Shukla, the chief of anesthesiology for the NSHA’s central zone.
Dr. Shukla says the Dartmouth Pain Clinic’s specialist, Dr. Robert Paterson, may continue to see patients after the closure date.
“He’s going to try to take some time to look after (patients) appropriately so that patients are looked after, whether it’s medication or other treatment he’s providing,” Dr. Shukla said.
For now, the wait list at the Pain Management Unit at the Queen Elizabeth II Health Sciences Centre in Halifax will grow. According to the NSHA, there are 850 patients on the Halifax Pain Clinic waitlist, and the 550 patients from the Dartmouth waitlist will be added to that.
The health authority says because patients are triaged for priority and based on new approaches to managing pain, patients are expected to be seen within 14 to 18 months.
However, one of the physicians at the Halifax Pain Clinic has told patients today that the wait list was between 13 and 16 months before the Dartmouth patients were added, and it is now more than two years.
Terry Bremner is an advocate for patients with chronic pain. He’s raised concerns before about patients feeling squeezed because of pressure on physicians to stop prescribing opioids.
Nova Scotia’s College of Physicians and Surgeons endorses a national guideline for prescribing opioids for chronic pain patients that was written this year. It recommends against the use of opioids.
Bremner says news of closure of the Dartmouth clinic is devastating, especially during National Pain Awareness Week, and he warns it will make it more difficult for patients to get care.
“We’re very complex individuals and we take up more time in the doctors’ offices, so the GPs want to pass us along to someone that specializes,” he said. “And that’s where we come into our wait times and these wait times are unacceptable.”