Patient says she has nowhere to go when pain clinic closes

A woman who has been a patient at the Dartmouth General pain clinic for about a decade says she has nowhere to go once the clinic closes at the end of the year and she runs out of medication.

Dawn Rae Downton was diagnosed with a rare inflammatory arthritis when she was 39 years old. 

"It caused me a great deal of pain. I was unable to stand, to walk, to sit, to lie down, and to sleep, so that's just about everything that I was unable to do," she said.

She said Dr. Rob Paterson at the Dartmouth pain clinic gave her her life back. That was until Oct. 3, when he told her he was retiring.

The clinic is closing because both doctors who work there are leaving. It means hundreds of patients with chronic pain will have to join a two-year wait-list to see a doctor at the Halifax Pain Clinic.

Downton, who has been using fentanyl to cope with her pain for 13 years, has been looking for a new doctor, but said she has been turned down multiple times. 

She declined to disclose her dosage, but said it is "appropriate" although it exceeds the recommended daily limit under new guidelines from the College of Physicians and Surgeons of Nova Scotia.   

Terry Bremner, president of the Chronic Pain Association of Canada, said Downton is not alone and there will be many patients unable to find new doctors.

"They do not feel comfortable in prescribing. Doctors in our province are very threatened by the College of Physicians and Surgeons in writing prescriptions for chronic pain people," he said.

The college was unable to provide comment Friday as its CEO was out of the office.

Downton said she will be out of the drugs she needs to live by the end of the year and feels she will be left with two options.

"The first one I don't like very much and it is to go to street to a dealer. They're very expensive and I'm not really sure that I would be getting what I thought I'm getting," she said.

"My other option, which I think is a better option, but my husband does not, is to take my life."

'I don't have all the answers'

The Nova Scotia Health Authority said it is trying to help patients transition. One of the current doctors at the Dartmouth clinic is moving her practice and will take some of her patients with her.

The health authority is also trying to recruit an additional pain specialist. If successful, that will help alleviate the two-year wait-list.

The health authority recognizes there remain gaps in the system as a result of the closure, particularly when it comes to opioid treatment.

"It's an evolving field," said Dr. Romesh Shukla, chief of anesthesia for the authority's central zone. "I don't have all the answers at the moment."

If you are in distress or considering suicide, there are places to turn for support, including your doctor or Nova Scotia's Mental Health Mobile Crisis Team at (902) 429-8167. The Canadian Association for Suicide Prevention also has information about where to find help.