Photo: David Goldman, Associated Press
The stigma night in the training of doctors on how to treat patients become addicted to opioids such as pain medication.
Family physicians should be on the front lines of the fight against addiction, but many refuse to educate themselves on the addiction, despite the economic crisis that is rampant across the country, says the head of the medical education in the largest university hospital canadian mental health.
Dr. Peter Selby, Centre for addiction and mental health in Toronto, said that discrimination and stigma are detrimental to the training of physicians on how to treat patients become addicted to opioids such as heroin or pain medications.
“That comes from this fundamental lack of understanding and training on how to help people living with an addiction as a medical condition, he explained, in a telephone interview from Toronto. It is still seen as something that are bad people. “
Dr. Selby is unacceptable that doctors say they do not know enough about this type of care. The addiction treatment should be integrated with primary care so that patients can trade in the substance that they abuse to drugs such as methadone and suboxone, both of which reduce the withdrawal symptoms.
It has a core of whole of registered doctors in Canada are refusing to accept patients with an addiction, who do not provide care based on evidence. And it leads to massive consequences, such as overdose and death.
Dr. Peter Selby, Centre for addiction and mental health, Toronto
According to Health Canada, 2816 persons have died of alleged overdoses of opioids by 2016 the country. This year, the most recent figures available are state-of-602 fatal overdoses between the months of January and march only.
On the side of the British Columbia, 1208 fatal overdoses have been recorded between the months of January and October, 683 more than in the same period of the previous year.
The anger of a doctor
Leslie McBain tells his son, Jordan Miller, was feared to have developed an addiction to oxycodone that had been prescribed for a back injury.
She accompanied him when he went to see a doctor, who would be angry when the issue of drug abuse has bubbled to the surface.
“He is inflamed,” Mrs. McBain, one of the founding members of the group Moms Stop the Harm, which supports some 300 canadian families who have lost a loved one due to an overdose.
“I’ve never seen a professional lose his cool like that. It was ugly, ” she recalls. I was sitting in the office, I only observe and I said to myself : “My son came here, taking her courage in both hands to say that he need help and doctor him yell.” “
She and her husband then took their own measures to bring their only son into a detox centre in British Columbia, but it was not able to find a counselor, a psychiatrist or an expert in addiction for the support during the two months that followed his stay, during which he was struggling with the painful withdrawal symptoms.
Jordan Miller was then experienced a relapse and “shopped doctors” in clinics without an appointment in search of prescription drugs to alleviate his agony. He died in February 2014, at the age of 25 years.
Leslie McBain laments that the recognition of addiction as a true chronic condition is made to wait within the medical profession.
It recognizes, however, that the institutions that train doctors strive to increase awareness of this effect and continue to educate those who show interest in this issue.
A complex treatment
The director-general of the professional development and support to practice at the College of family physicians of Canada, Jeff Sisler, highlights that the treatment of addiction is seen as complex and less attractive than the other specializations.
“But the clinical demand and social pressure for the doctors to manage this are being felt “, he says.
The College seeks to put physicians in contact with networks of mentoring, the example of Ontario, where they have access to experts online, through texting or even by phone, he adds.
“It is a long-term relationship between family physicians and ordinary people with more expertise to provide information tailored to the individual and also to encourage, build confidence, meet some of the concerns raised by family physicians about these complex patients,” explains dr. Sisler. “We try to ensure that other provinces have similar networks. “
The director of the Center for drug of British Columbia Evan Wood, believes that addiction treatment must get rid of its image is repulsive. In his opinion it is a discipline, yet rewarding, because once treated, patients are making considerable progress.
“We want people to understand that it is one of the most exciting in medicine at this time “, he explains.
Dr. Wood believes, however, that despite the efforts of recruitment and training, a system of premiums is required.
To treat a patient at the suboxone can take up to three hours the first day only, shows-t-it.
The doctors already receive bonuses for the methadone treatment for other chronic conditions such as diabetes and hypertension.
“If it takes two times more time, and that it is paid two times less, there will not be enough doctors altruistic to face it,” says Mr. Wood.