Pubdate: Sat, 27 Aug 2016
Source: Toronto Sun (CN ON)
Page: 50
Copyright: 2016 Canoe Limited Partnership
Author: Dr. W. Gifford-Jones


High-Dose Opiods Ease Dying Patients' Suffering

How history repeats itself! Today, politicians are once again 
ignoring the pain of terminal cancer patients. At the same time they 
are shooting themselves in the foot by making illogical remarks about 
pain. This human folly takes me back 37 years.

In January 1979, I wrote a New Year's resolution in this column to 
petition the government to legalize medical heroin to ease the agony 
of terminal cancer patients. I knew that heroin had been used in 
English hospitals for 90 years, so why not have this painkiller 
available in North America? But rather than being applauded for my 
compassion, all hell broke loose.

One well-known cancer specialist labelled me "a misinformed 
headline-seeking journalist." The Cancer Society argued that morphine 
was as good as heroin "in most cases." It provided no alternative if 
you were not one of the "most cases." Besides, it's a physiological 
fact that heroin is more potent than morphine. The Royal Canadian 
Mounted Police and The Journal of Hospital Pharmacy worried about 
security. And doctors who damned the use of heroin had to admit they 
had never used it. So much for scientific curiosity!

The volume of negativity around heroin was so intense I decided to 
visit England and Scotland to get a first-hand look at how heroin was 
used in these countries.

One of the most heartrending moments was when I visited the Great 
Ormond Street Hospital in London where children were dying of cancer. 
I asked why heroin was prescribed? The nurses replied, "They prefer 
heroin as it eases their pain and gives them a fuzzy feeling." 
Surely, I thought that was the least that could be done for them.

In London, I interviewed Scotland Yard detectives who told me there 
was no problem with security. They and the Drug Officials in 
Edinburgh said they had more important problems to worry about.

I discovered that heroin was the first medication emergency doctors 
administered to heart attack victims, to relieve their pain and 
anxiety. Doctors were also prescribing heroin to women with difficult 
childbirth, and patients with severe burns. And family physicians 
told me they always carried heroin in their bags in case they 
encountered an accident where it was needed. In other words, all I 
had heard from the medical establishment in Canada was untrue.

So what happened? On my return I wrote more columns about the medical 
need of heroin. Finally readers who had lost a loved one and 
witnessed their final agony, sent me letters and money to promote 
this cause. Eventually I delivered 40,000 stamped letters (not 
e-mails) to the federal minister of health in Ottawa all demanding 
that politicians legalize heroin for terminal cancer patients.

On Dec. 20th 1984, the Minister of Health announced the government's 
intention to legalize heroin as a painkiller. $500,000 from readers' 
donations then established the Giffford-Jones Professorship in Pain 
Control and Palliative Care at the University of Toronto Medical School.

So 37 years later? Now the minister of health of Ontario has 
announced that doctors will no longer be able to prescribe high-dose 
opioids to either addicts or cancer patients. It's an asinine ruling 
that must be challenged. Everyone must ask this question, "Why should 
a loved one in final agony be denied high doses of opioids just 
because addicts want to get high?"

The lack of good sense remains the same. For example, an official 
associated with this study remarked, "It is reassuring that the vast 
majority of palliative care patients will not be impacted by this 
policy." Why would anyone make such a foolish statement? Isn't there 
any empathy for others who will be impacted?

Families of the dying should vigorously protest when loved ones 
suffer from inadequate painkillers. English specialists told me 
patients in severe pain do not become addicted to painkillers and can 
be weaned off huge doses quickly if remission of malignancy occurs.

It's hard to believe that cancer patients with a few days to live are 
denied sufficient painkillers for fear of addiction. Today common 
sense has become an uncommon commodity.

EDITOR'S NOTE: The column does not constitute medical advice and is 
not meant to diagnose, treat, prevent or cure disease. Please contact 
your doctor. The information provided is for informational purposes 
only and are the views solely of the author.
- ---
MAP posted-by: Jay Bergstrom