Tens of thousands of Canadians are living with unrelenting pain that can be isolating, demoralizing and deadly, a national summit on pain heard Tuesday.
Access to pain relief is a fundamental human right, yet waiting times for pain care in Canada grow longer by the day, pain doctors and leaders of patient groups say.
Many patients who need opioids to help control pain can't find a family doctor willing to treat them, the one-day gathering in Ottawa heard. Even children are suffering under-treated and poorly managed pain.
Chronic pain "assaults us physically, emotionally and spiritually," said Lynn Cooper, president of the Canadian Pain Coalition. "Pain can be devastating, debilitating, demoralizing and dehumanizing. And all too frequently, it turns deadly."
Those living with chronic pain experience stigma, discrimination and the "shame of pain, when we are labelled as complainers, malingerers and drug seekers," Cooper said.
"Access to pain management is a right not being met in Canada," she said. "Canada as a developed country has a moral imperative to do better than this. We can do better than this."
It is estimated that one in five Canadians - about six million people - is living with chronic pain of some kind. In the next two decades, as the population ages and modern medicine allows people to survive serious illness, that ratio is expected to swell to one in three.
Pain researchers, doctors and patient groups want a national pain strategy that would see more specialized pain clinics, more training of doctors in the diagnosis, treatment and prevention of pain and improved community-level care.
The summit heard that six to eight per cent of children in Canada live with intense and frequent pain - persistent pain from surgery or trauma, juvenile fibromyalgia, arthritis, chronic headaches and chronic abdominal pain - but that children have even poorer access to pain treatment than adults.
"Imagine being the parent of a child with cancer who won't even let you hug her because it hurts too much," said Dr. Allen Finley, professor of anesthesia and psychology at Dalhousie University in Halifax, and a world leader in pediatric pain management.
"Imagine being a teenager with chronic pain who nobody believes. Imagine being too young to find the words to say, it hurts," said Finley, medical director of pediatric pain management at IWK Health Centre in Halifax.
He said one of his patients described the pain as feeling like "meat knives carved into my joints, running through my bones and jabbing into my soft tissues. And it's not the kind of thing you get used to, either."
Finley said there are "hugely more children" affected by pain than the half-dozen pediatric pain clinics across the country can begin to handle.
"We need another strategy," he said. "We need more staff and support to not only treat those kids directly but also to build capacity in primary care to prevent problems from becoming difficult," he said.
People with chronic pain are stigmatized and frequently treated as addicts, or would-be addicts, the summit heard.
"What a cruel thing to do someone who is already suffering from pain," said Dr. Michael Cousins, director of the Pain Management Research Institute at the University of Sydney in Australia.