Canadian Pain Fact Sheet

Pain in Canada Fact Sheet

Pain is poorly managed in Canada

  • Although we have the knowledge and technology, Canadians are left in pain after surgery, even in our top hospitals
  • Only 30% of ordered medication is given, 50% of patients are left in moderate to severe pain after surgery and the situation is not improving (Watt-Watson, Stevens et al. 2004; Watt-Watson, Choiniere et al. 2010)
  • Growing evidence has identified that many common surgical procedures cause persistent post-operative pain that becomes chronic (Kehlet, Jensen et al. 2006)
  • Uncontrolled pain compromises immune function, promotes tumor growth and compromises healing with increased morbidity and mortality following surgery (Liebeskind 1991)
  • One in five Canadians suffer from chronic pain, children are not spared and the prevalence increases with age (Moulin, Clark et al. 2002; Schopflocher, Jovey et al. 2010)
  • Many cancer and HIV survivors have greater quantity of life but unfortunately a poor quality of life due to chronic pain conditions caused by the disease or the treatments that cause irreversible damage to nerves (Levy, Chwistek et al. 2008; Phillips, Cherry et al. 2010)
  • Chronic pain is associated with the worst quality of life as compared with other chronic diseases such as chronic lung or heart disease (Schopflocher, Jovey et al. 2010).
  • Chronic pain costs more than cancer, heart disease and HIV combined. Estimates place direct health care costs for Canada to be more than $6 billion per year and productivity costs related to job loss and sick days at $37 billion per year (Phillips and Schopflocher 2008; Schopflocher, Jovey et al. 2010)
  • There is double the risk of suicide as compared with people without chronic pain (Tang and Crane 2006)
  • A recent review of opioid (narcotic) related deaths in Ontario, identified the tragic fact that pain medication related deaths in Ontario are increasing and that most of the people who died had been seen by a physician within 9-11 days prior to death (emergency room visits and office visits respectively) and the final encounter with the physician involved a mental health or pain related diagnosis. In almost a quarter of the cases the coroner had determined that the manner of death was suicide (Dhalla, Mamdani et al. 2009)
  • Veterinarians get 5 times more training in pain than people doctors and 3 times more training than nurses (Watt-Watson, McGillion et al. 2008)
  • Pain research is grossly under-funded in Canada (Lynch, Schopflocher et al. 2009)

References:
Dhalla, I. A., M. M. Mamdani, et al. (2009). "Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone." CMAJ 181: 891-896.
Kehlet, H., T. S. Jensen, et al. (2006). "Persistent postsurgical pain: risk factors and prevention." Lancet 367: 1618-1625.
Levy, M. H., M. Chwistek, et al. (2008). "Management of chronic pain in cancer survivors." Cancer J 14(6): 401-409.
Liebeskind, J. C. (1991). "Pain can kill." Pain 44: 3-4.
Lynch, M. E., D. Schopflocher, et al. (2009). "Research funding for pain in Canada." Pain Res Manage 14: 113-115.
Moulin, D., A. J. Clark, et al. (2002). "Chronic pain in Canada, prevalence, treatment, impact and the role of opioid analgesia." Pain Res Manage 7: 179-84.
Phillips, C. J. and D. Schopflocher (2008). The Economocs of Chronic Pain. Health Policy Perspectives on Chronic Pain. S. Rashiq, P. Taenzer and D. Schopflocher. UK, WIley Press.
Phillips, T. J. C., C. L. Cherry, et al. (2010). "Painful HIV-associated sensory neuropathy." Pain Clinical Updates XVIII (3): 1-8.
Schopflocher, D., R. Jovey, et al. (2010). "The Burden of Pain in Canada, results of a Nanos Survey." Pain Res Manage: In Press.
Tang, N. and C. Crane (2006). "Suicidality in chronic pain: review of the prevalence, risk factors and psychological links." Psychol Med 36: 575-586.
Watt-Watson, J., M. Choiniere, et al. (2010). "Prevalence, characteristics and risk factors of persistent post-operative pain after cardiac surgery." World Congress on Pain Montreal: Abstract.
Watt-Watson, J., M. McGillion, et al. (2008). "A survey of pre-licensure pain curricula in health science faculties in Canadian universities." Pain Res Manage submitted: xx-xx.
Watt-Watson, J., B. Stevens, et al. (2004). "Impact of preoperative education on pain outcomes after coronary artery bypass graft surgery." Pain 109: 73-85.