22 Aug The Program is watching you

A curmudgeonly friend writes:

Last winter, the Nova Scotia Prescription Monitoring Program ruined my wife’s first vacation in eight years.

The Program exists to restrain the abuse of prescription drugs, something I thought prescriptions themselves were for. To this end, among other things, the Program provides the police with information about legal (that is to say legal) drugs you are taking (you may have thought that information was confidential).

But the hammer in the Program’s toolbox is its ability to intimidate doctors out of doing what they believe is right for their patients. To wit, from the Program’s FAQ: “If the Program has reason to believe that a doctor, dentist, or pharmacist may be practicing in a manner that is inconsistent with the mandate of the Program, the Program may refer the case on an anonymous basis to the Programs Practice Review Committee (PRC) for review. The PRC may choose … to refer the individual to their licensing authority for further review. The Program … shall provide the licensing authority with all relevant information.”

It’s a big hammer because, win or lose, being the subject of proceedings by your licensing authority is stressful and sometimes ruinously expensive.

Enter my wife, M. She has a painful chronic disease. Worse, one of the few drugs that can help control her pain is the opiate OxyContin, the mellifluous, beloved favourite of media in search of hysterical stories about drugs.

M knows all this. So in planning our vacation, she calculated the number of OxyContin pills she would need to endure our flight and two days or so after our arrival. She did the same math for the return trip. She then asked her family doctor, a good one, for a prescription, being careful to explain why she would need each pill.

But the doctor refused to prescribe all the pills she wanted. This had nothing to do with M’s medical history. The doctor knew that she had previously taken the same medication in very high doses without becoming “addicted”. It was also clear that she had refrained from peddling her pills on the street over the previous eight years (there’s only one entrepreneurial bone in her body and it’s in pain). It was obvious that the Program was casting its shadow over her putatively confidential relationship with her physician.

As the good doc put it to M in a subsequent conversation: “(The Program) is monitoring me, and it’s monitoring you, too.” In other words, woe unto the doctor who comes to the attention of the Program.

So M spent a considerable portion of her vacation in bed because she didn’t have enough medication to manage the pain caused by the effort involved in travelling to our resort. (Note: people with debilitating chronic pain need vacations just like the rest of us.)

Of course, this was a mere skirmish in the saintly “war on drugs”, but it’s a big deal when someone you love becomes collateral damage. Who’s in charge of my wife’s health, her doctor or the Program? Her doctor has known her for more than 10 years; the Program apparently has difficulty knowing whether or not she’s a junkie.

Dear fellow taxpayers, if you want to spend billions playing cops and robbers with dopers, with no victory in sight, be my guest. But my wife and others need legally prescribed drugs to control pain. They didn’t sign up for your war. So, if you insist on forcing a choice between people in pain and people stupid enough to take drugs they know are dangerous and weren’t meant for them, then please bring the consequences down on the heads of the abusers. Life is full of dire consequences. Junkies, would-be junkies, and the parents of would-be junkies all know that. Or ought to. M is not responsible for their choices.

Let the abusers have their illicit pills. Shut down the Nova Scotia Prescription Monitoring Program. Leave my wife in peace. Let her doctors do their jobs.