CDC Opioid Guidelines Push Patients to the Street to Find Pain Relief

It should be obvious to anyone with even a bit of compassion and common sense that those who are suffering in great pain should be able to access the medication they need to alleviate that pain.  It’s also an issue that cuts right to the heart of what libertarians believe: that every person has the right to self-determination, and government has no right to tell people what they can and cannot put in their bodies. Now, I realize the BC College of Physicians and Surgeons technically is not a government entity, but as they hold a government-granted monopoly on the profession, it amounts to the same thing.

In the Centers for Disease Control guidelines for prescribing opioids that the College has adopted, I see the following, “Clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient,” and “When opioids are started, clinicians should prescribe the lowest effective dosage.” To my layman’s understanding, this is highly troubling. The “risks” described surely refers to addiction. No person can truly feel another person’s pain, so it is impossible for a doctor or anyone else to weigh the perceived risk against potential benefit (relief of pain) except the patient herself. Furthermore, the weight assigned to the risk (of addiction) in this calculation, is largely a matter of subjective moral perception, not of scientific fact. That being the case, assuming the patient is mentally competent, this decision should be hers to make.

The dark irony of the CDC guidelines is that because people in great pain cannot get sufficient medication through legal channels, they turn to the street. Of course it is very difficult to ascertain the quality and potency of drugs purchased through the black market, and many of those who have gone this route have consequently died of overdoses. Beyond that are the health risks social harms that come with engaging in the street drugs scene: HIV, Hep C, arrest, loss of livelihood due to a criminal record, loss of friends and social standing from living on the margins of society, and so on.

The BC Libertarian Party believes that the best way to reduce these risks and harms is legalize all drugs. We also believe that patients and doctors should be allowed to freely contract for services, and that the BC College of Physicians should not have a monopoly on providing healthcare services in this province. Implementing these two measures has the potential to transform our healthcare system from one of paternalism to one of mutual respect and voluntary consent. In such a framework, patients would be able to get the pain medication they need, and would not have to risk their lives doing so.

Clayton Welwood
British Columbia Libertarian Party Leader