I recently came across an article/study that looks into the problem of methadone availability in Canada (read the study here ) that points out how the drug itself is viewed and used differently here. In the US, methadone is now used to treat chronic pain for those who have built up a tolerance for most opiates, or who may have allergies to them (many opiates can cause rash and painful skin swelling), and is beginning to lose the stigma attached to it form years of being used to treat addiction to illegal drugs. My own methadone prescription was given to me for that sole purpose: years of being on drugs like oxycodone, vicodin, percoset had made me overly tolerant to the effects of those painkillers, rendering them fairly useless. The next best thing was to go on methadone to manage my chronic aches and pains. And it was prescribed by a palliative care doctor - someone who manages the pain of those suffering from cancer.
But in Canada, methadone retains the ugly stigma related to drug abuse - and for good reason: it is only used here for that express purpose - to manage heroin and cocaine withdrawal. That, too, explains the reluctance of doctors to get licensed to prescribe and dispense it. So therein lies my problem in finding a doctor who will refill my prescription - it will probably be interpreted as a step towards furthering an addiction (which couldn't be farther from the truth).
So while I ponder my options (check with the drug and alcohol addiction center in town and see what they might recommend; continue to pester the one doctor who can prescribe it but who is too backlogged to take on any new patients until he capitulates; go to the hospital in town and let them know that they can either refill my scrip or see me in a few weeks when I go through withdrawals), I have written to my old palliative care doctor in the States to see what, if anything, he can do to help (be that contacting said overloaded doctor or offering advice on how to get off of the drug at home, or finding a way for me to refill it in the States). The problem is that I need to personally take the paper prescription request into the pharmacy - it is not a drug that can be faxed in by the doctor. This poses the biggest obstacle - if it could be faxed, I'd have him send it to a pharmacy in Los Angeles and have my wife pick it up when she is there on business this next week).
In the meantime, I have taken the matter into my own hands. I have started reducing my daily dose, against the recommendation of just aboot everyone on the planet who knows aboot methadone withdrawal. BUT, after 2 days of taking half my regular dose at bedtime, I have found the next morning no different than normal. No massive migraines, vomiting, hallucinations, vertigo, diarrhea, or anything else described by those who have experienced methadone withdrawal. I am, though, on a much lower dose than most who are sentenced to daily methadone intake. Hopefully, 2 days in a row without major withdrawal symptoms is a good harbinger that my plan to taper off completely will go smoothly and without issue (or hospitalization).
I will not let the Canadian health care system ruin my new life here in Canada!
I will still be battling to have someone handle this issue professionally in the next few days. I will not give up trying to get someone to honor their oath and take me on as a patient, and tend to me in the manner I need. Battling doctors has become almost second nature to me in the last 10 years. It is the crux I bear as someone with a rare, incurable, pain-in-the-ass condition.
So stay tuned as I start my campaign against the apathy and prejudice of Canadian doctors.
And for those who really could care less aboot the whole doctor thing, I will continue to provide my observations aboot Canadian culture in general, don't you worry, eh.
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Good grief, someone blogging from my hometown. What are the odds?
ReplyDeleteI've been amusing myself making my way through the backlog of posts you've been making indulging in a bit of nostalgia since I haven't made it back to Kelowna in a couple of years, and felt compelled to make a few observations on this particular subject.
As you touched on when you first started discussing it, your methadone access issues are not so much a problem with the "Canadian Health Care System" as they are with a combination of the population levels and density of the particular place you decided to relocate to, and differences in the legalities of methadone in Canada. In the US methadone is only considered a Schedule II drug which requires a prescription while in Canada, as you discovered, it's treated a little more seriously than that. Anyone who was raised within the Canadian system from the beginning would have been far less likely to have been prescribed it in the first place as a pain management measure so access to it in more remote locations would be less of a concern, but since you were transplanted into the system... problems ensue.
As to the issue of wait times, that is also not really a problem with the health care *system*, it is rather a combination of the geographic distribution of the population (you can run into similar problems with the supply of doctors and specialists in any remote low population area of the US as well) and a budgeting priority issue. The Canadian system could quite easily accommodate far lower wait times and increased access to specialists by simply throwing money at it, but given the choice between wait times and national fiscal health the choice in Canada has tended to come down on the side of balanced and sustainable budgets being more important than increased convenience (I'm not trying to trivialize your problem by referring to it that way btw).
That is not to say people won't still complain bitterly about those wait times, but ask them if they want to run deficits to get them and they tend to say no. (And ask them if they want a US style private sector health system and they say *hell* no... that's the stuff of scary political attack ads in Canada... which is amusing considering they do the exact opposite for scary political attack ads down here)
Living in the US for the last ten years, the opposite tendency seems to apply down here. People will complain bitterly about the budget deficits and the generally exorbitant costs of health care and demand that Something Be Done... but asked if they want to sacrifice any creature comforts or conveniences of any programs they themselves utilize to get rid of those deficits and, well... not happening. They always seem to expect that these reductions should happen without any actual negative consequences and are outraged when the government doesn't just make that happen.