Pain BC. Changing Pain. Changing Minds.
October 2018 Update
 
From our Executive Director, Maria Hudspith 
 
Recreational cannabis has now been legalized in Canada. This has the potential to have significant impacts on the lives of people living with pain in Canada. What are some of the possible effects?
 
We expect that the legalization process will be bumpy – most big regulatory changes are. There are always things that come up as policy is implemented which are not able to be anticipated in advance, along with confusion about what exactly the new rules are. One of the concerns raised by people living with pain, and some cannabis dispensaries, is that access to medical cannabis may be disrupted by the legalization process. Each provincial government will be managing their own approach to cannabis sales and enforcement. In BC, the provincial regulatory framework for cannabis indicates there will be an online, government-run platform for cannabis sales as well as licensed retail outlets. The provincial government has said that current retail stores that are not licensed under the new system will be shut down. While some people living with pain access medical cannabis through the federal government’s program, many others utilize local dispensaries. This new system may create confusion about where to access cannabis for medical purposes, along with barriers to access for some medical users.
 
Some retailers have also warned about a gap in supply as current retail outlets will need to get rid of “unauthorized” cannabis produced under the old law; it’s unclear whether demand created by legalization will outstrip supply and whether people in pain who use cannabis will be unable to access it immediately.
 
We expect that legalization will create a cultural shift and reduce the stigma associated with using cannabis. Growing acceptance for cannabis may mean that more people try it for pain relief. People living with pain should approach cannabis like any other treatment: understand the evidence, talk to their health care team, explore the risks, and if they decide to use it, do so on a trial basis while monitoring the impacts on their pain and overall function.
 
The cultural shift means that more people will be asking their health care providers about cannabis. We want to ensure that health care providers are armed with good information for that conversation. The Canadian Pharmacists Association recently published a resource, Cannabis for Medical Purposes: How to Start the Conversation, which provides some guidance on how best to respond to patient questions.
 
We also want to ensure people in pain are equipped with the right tools to inform their decisions around cannabis. Our Live Plan Be self-management resource website offers useful resources on cannabis, which are highlighted in more detail below. The most recent episode of our Pain Waves Podcast provides a unique lens on medical cannabis for pain, where clinical pharmacist Terri Betts and her daughter Nikki join us to provide both an evidence and experiential based dialogue on the use of cannabis for pain relief.
 
We’re interested in your stories about how legalization has affected you and how you think this change will impact people in pain. Join the discussion on our Facebook page!
 
TABLE OF CONTENTS
 
Live Plan Be  Connect for Health
 
New Pain BC website: key features and ease of navigation 
 
Pain BC is excited to announce the launch of our new website! People in pain and health care professionals can now easily navigate through our website to find the information and resources they're looking for.
 
Some key new features include:
 
How We Can Help: A list of all Pain BC programs and resources available to help people manage the physical, emotional, and practical effects of chronic pain in their life.
 
Find Help Near You: People in pain can search this database to find help in their community. The database includes pain courses, workshops, and support groups; pain clinics; and a list of health care providers who have completed accredited pain management training.
 
Blog: A space for relevant chronic pain news, events, stories and other opportunities available for people living with pain.
 
Assessment Tools and Clinical Guidelines: These pain assessment tools are in the public domain and are available to all health care providers to assist them in better understanding the impact of pain on a person.
 
Professional Education Directory: A centralized list of all upcoming pain related education opportunities for health care professionals.
 
Pain Waves Podcast: Cannabis for chronic pain 
With Terri Betts, Clinical Pharmacist and her daughter Nikki, a person with chronic pain
 
With recreational cannabis now legalized in Canada, it’s likely that more people in pain will consider it for pain relief. In this episode, Clinical Pharmacist Terri Betts and her daughter Nikki, who lives with chronic pain, share their story about navigating the health care system after Nikki decided to pursue medical cannabis to manage her pain. She had previously tried a variety of pharmaceutical medications, including opioids, without much success. Throughout our discussion, the two touch on the bodies of evidence available along with other key resources that helped them throughout their decision-making process.

Please note that as with any other treatment method, we advise anyone wishing to pursue medical cannabis for pain to first consult with a licensed health care professional.
 
 
Cannabis resources for people in pain 
 
Now that recreational cannabis has been legalized, here are some Live Plan Be articles for anyone considering using cannabis for pain relief:
 
Patient engagement at the IASP World Congress on Pain 
Guest post by Keith Meldrum
 
Recently, I was invited to participate at the International Association for the Study of Pain (IASP) World Congress on Pain. IASP is an international organization bringing together scientists, clinicians, health-care providers, and policymakers to stimulate and support the study of pain and translates that knowledge into improved pain relief worldwide. IASP represents over 7,000 members worldwide and their biennial conference was held in Boston, Massachusetts from September 12-16. 
 
I was privileged to be one of three people invited to attend and present a workshop on living with persistent pain. This was the first year IASP invited people with persistent pain to take part in their Congress activities. Although I knew my co-presenters, Joletta Belton and Pete Moore through social media, this was our first in-person meeting and it was like meeting old friends who hadn’t seen one another in a long time.
 
My presentation, The Patient Voice, Self Management, and Resiliency: The Patient Perspective was based on 32 years of experiences following a near fatal car accident in 1986. In the workshop, I discussed how one can find the best ways to live with pain as we learned through scientific evidence. The underlying theme of my presentation was validation; having health care providers validate that the patient’s pain is real. I attended both Joletta and Pete’s presentation, which were amazing, as they offered insight into their lived experiences and how they have been able to move forward and find the best ways to live well despite pain. Feedback on our presentations was overwhelmingly positive.
 
In addition to my workshop, I was also asked to be a member of IASP’s newly formed Global Patient Alliance. The purpose of the Alliance, as identified by IASP, is to identify the current state of global challenges around pain management, identify barriers to effective solutions, and offer manageable and achievable solutions that foster strategic collaboration among organizations and advocates at the global and national levels. This sounds daunting and is clearly a large list of deliverables, but I offer that at a foundational level, our task is to help identify how to bridge the gaps between people with pain and effective pain management solutions - a critical missing piece for many people throughout the world...
 
 
4th Annual Pain CARE & Share Conference 
November 7, 2018 in Victoria
 
As part of National Pain Awareness Week (November 4-10, 2018), Island Health, Pain BC, and the UVic School of Nursing are partnering on the 4th Annual Pain CARE & Share Conference in Victoria.
 
The conference will focus on pain care and will include interactive learning opportunities through story-sharing, discussions, and current practice and research. This year's theme is based on the International Association for the Study of Pain (IASP) Global Year of Excellence in Pain Education with topics including persistent pain strategies, opioid safety, and cannabis legalization.
 
Tickets are by donation and are open to people in pain, caregivers, health care professionals and students. 
 
 
Pain Foundations launching January 2019 
Online chronic pain course for health care professionals
 
Pain Foundations is an online course designed for health care professionals of all disciplines to address the challenges faced when assessing and treating people living with chronic pain. 
 
Course launch date: January 7, 2019
Cost: FREE for health care professionals who pre-register before December 31, 2018
 
Please share this opportunity with any health care professional who would benefit from taking the Pain Foundations course.
 
 
New survey from Health Canada on strengthening Canada's response to substance use  
Survey available until December 4, 2018
 
A new survey from Health Canada is seeking feedback from the public on how to better address problematic substance use in Canada from a health perspective. The survey includes a specific piece on the needs of people in pain. The survey will remain open until December 4, 2018.
 
 
Study invitation: Immersive Multimedia Experiences for Cancer Patients with Chronic Pain 
 
The UBC School of Nursing and SFU School of Interactive Arts + Technology are recruiting people living with cancer to test the use of an immersive multimedia experience to help manage their chronic pain. More information about this study can be found here. Those who are interested in participating are encouraged to contact Crystal Sun, Project Manager at crystal.sun@ubc.ca.
 
Upcoming webinars: In partnership with WWDPI 
 
Work Outcomes in Self-Employed Cancer Survivors
Details coming soon.
Nov 27, 2018 8:30-9:30am PST: Find out more
 
Pain BC is a program partner for the Chronic Pain Webinar Series hosted by the Work Wellness and Disability Prevention Institute. 
Upcoming Pain BC and partner events 
Interdisciplinary Pain Education Day: Current topics in pain management
Pain BC is partnering with Providence Health to deliver this fantastic day of pain talks on topics including: Managing Pain and Addiction, Pain and Ethics, The Cannabis Question, Resilience,  Prescription Opioids and Pain, and Soundscapes, Music and Pain.
Oct 19, 2018 at St. Paul's Hospital: Find out more
 
Pain BC Webinar | Acupuncture and Chronic Pain
In this webinar, Dr. Teresa Clarke, staff physician in the Complex Chronic Diseases Program at BC Women’s Hospital will present on her work providing acupuncture treatment to people living with chronic pain. 
Oct 24, 2018 12-1pm PST: Register now
 
Pain BC Webinar | The Cannabis Question: Culture to Science
Clinical pharmacist Terri Betts will speak to many of the question providers have about prescribing cannabis for chronic pain.
Nov 14, 2018 12-1pm PST: Register now
 
Chronic Pain Management for Occupational Therapists 
A workshop for occupational therapists interested in learning about the neurophysiology of pain and how it relates to OT intervention.
Jan 11-12, 2019 - Vancouver: Register now
 
Pain BC programs and initiatives are funded, in whole or in part, by the Government of British Columbia.
 
In the News
In the News 
 
People in pain who use cannabis to manage their pain are likely to be impacted by its limited availability during the initial stages of the legalization process.
 
This article makes a critical point about the urgent need for publicly funded alternatives to opioid medications in order to better address the needs of people living with chronic pain.
 
Lady Gaga was recently featured in Vogue magazine, where she opened up about living with chronic pain as a result of her fibromyalgia.
 
A physician shares his story on developing chronic pain and the process behind how he learned to best manage his symptoms.
 
New data has been published indicating that prescribed opioid medications have not played a significant role in the overdose crisis in BC.
 
This article explores the need for caution when reducing opioid prescriptions and the importance of making non-pharmacological treatment options more accessible and affordable.
 
 

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