Re: WorkSafeBC’s multimodal approach to chronic noncancer pain management

WorkSafeBC appears to conclude that opioids are not useful for injured workers unless they help people get back to work. This article [BCMJ 2019;61:176,179] contains insufficient information in making conclusions about the use of opioids to help injured workers with chronic noncancer pain return to work. Patients in this group may not be able to return to work but may sleep better, have improved mood, and have better family relationships with proper pain control. The article is also missing key information about the nature of the injuries incurred by these workers (e.g., severe electrical event, loss of limb, severe back injury, head injury). It is true that the use of opioid analgesics for chronic pain is a last resort, following treatment with rehabilitation therapy, acupuncture, etc., in all but extreme cases. Physicians are not to blame for the appalling epidemic of deaths due to street fentanyl. The current restrictions arising from the epidemic have left many patients in a painful limbo, which may lead many of them to turn to these same dangerous street drugs.
—Helen Hays, MD, CCFP, FCFP
Black Creek

This letter was submitted in response to “WorkSafeBC’s multimodal approach to chronic noncancer pain management: New hotline for physicians.”

Helen Hays, MD, CCFP, FCFP. Re: WorkSafeBC’s multimodal approach to chronic noncancer pain management. BCMJ, Vol. 62, No. 1, January, February, 2020, Page(s) 11 - Letters.



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About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

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