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With opioids, a stupid concept leads to stupid results

Re: “Responsible Opioid Prescription Use Essential” Letters to the Editor, St. Albert Gazette, Saturday, August 10th, Francois P.

Re: “Responsible Opioid Prescription Use Essential” (Your Views, St. Albert Gazette, Saturday, Aug. 10th, Francois P. Belanger, Vice-President, Quality and Chief Medical Officer, Alberta Health Services):

I read with interest the letter to the editor “Responsible Opioid Prescription Use Essential” in the Aug. 10th issue of the St. Albert Gazette from Dr. Francois Belanger, Vice-President, Quality and Chief Medical Officer, Alberta Health Services. In this letter, Dr. Belanger states that “under no circumstances does AHS interfere in the clinical decision making process between individual physicians and their patients and supports physicians’ professional obligation to advocate for patients and freely express concerns regarding our province’s health system."

Throughout my life, I have found that when a leader needs to state “you are free to express your concerns,” it is a direct result of a system that has not tolerated such expressions in the past.

Let’s be clear: the previous NDP government launched an all-out war on opioid use in the province of Alberta. This war was targeted at legal users of opioids (since it was not possible to target illegal users, who make up the majority of the problem). Patients concerns were of no consequence in this war – all that mattered was results. Doctors were intimidated by heavy-handed threats from the government, and concerns about retaining licenses to practise medicine were routinely suggested.

The concept was stupid, but it worked: many, many doctors “ran for cover,” while those who stood their ground and fought for their patients were outgunned and outmanned. Naturally, a stupid concept leads to stupid results and that’s what happened. Patients were routinely abandoned, with no options except illegal opioids or suicide.

Dr. Belanger’s article goes to great lengths to explain all the services and support that physicians can call on from AHS, and one could easily come to the conclusion that the system is working wonderfully. In business, there’s an old saying that “the only opinion about the quality of a product that matters is the customer’s,” and in medicine, “only the patient can decide on the effectiveness of a treatment.”

Unfortunately, the system is not working wonderfully, and I suggest if you have any questions about this statement, you go and talk to some of the pain patients who were impacted by this disastrous program. Moving forward, let’s stop the public relations efforts and assigning the blame, and focus on the patients – and intelligent, effective solutions.    

Brian McLeod, St. Albert