'I'm not a druggie': Nova Scotian travels to U.S. to fill opioid prescription

A Nova Scotian living with chronic pain has had to go to the U.S. to get her opioid prescriptions filled because she can't find a family doctor in the province.

Michelle Lutz, 44, said she put herself on the wait-list for a family physician shortly after moving to Halifax from Washington with her family four months ago — and she's still waiting.

There are currently 37,339 people on the wait-list for a family doctor in Nova Scotia. 

• 6 things you need to know about opioids

Without a family doctor, Lutz said she has no way to get oxycodone and hydrocodone to treat her chronic pain caused by a variety of conditions, including fibromyalgia, a damaged spinal disc and an autoimmune disorder called Hashimoto's thyroiditis.

"I can't bend over like people can. I have an extremely limited ... range of movement," she said, adding the medication "helps immensely."

'I'm not a druggie'

Lutz said, when she lived in the U.S., her doctor prescribed opioids and monitored her use. 

"I've never exceeded my number of pain pills," she said, "I'm not a druggie. I just use them because I have to for pain."

Lutz said she had her prescriptions filled shortly before leaving Washington, but ran out in September. 

She went to a walk-in clinic and the emergency room in Halifax seeking a refill, and was turned down in both places.

The doctor at the walk-in referred her to the pain clinic, with the caveat that it could take up to three years to get an appointment.

ER doctors in Nova Scotia can prescribe opioids, although some may refuse to do so for safety reasons.  

Lutz's husband eventually returned to Washington to refill her prescriptions.

ER doctor expresses concerns

The idea of a patient taking opioids without supervision raises concerns for Dr. Maureen Allen, a physician at St. Martha's Regional Hospital in Antigonish, N.S.

Opioids are "incredibly important" and "very effective," Allen said, but "they have some significant risks." If a patient is not being monitored, "they're at risk of developing opiate addiction," she said.

Monitoring options include urine tests and random pill counts, as well as requiring patients to sign treatment agreements and attend frequent followup appointments, but these strategies are not possible in an ER setting. 

Withdrawal is dangerous

Not all physicians see opioids as an effective treatment for chronic pain. In some cases, Allen said, they can make pain worse. 

But Allen said the most dangerous scenario is one in which a patient such as Lutz is unable to find any health-care provider to prescribe opioids, and is cut off completely. 

People shouldn't have to pack up and move because they can't get care. That's just unacceptable.- Michelle Lutz

The pain that accompanies withdrawal "feels life-threatening inside, and so these patients will do whatever they can to get access to these medicines," she said. "That's when we'll start to see them buying it off the street."

Lutz said she's been through withdrawal once, in Washington, when she accidentally destroyed a bottle of medication. Now, she's taking steps to prevent that from happening again.

"I'm terrified of that," she said, adding she's trying to ration her medication.

Lutz said she isn't sure moving to Nova Scotia was a good idea — or whether she can stay.

"People shouldn't have to pack up and move because they can't get care," she said. "That's just unacceptable."

CBC contacted the Nova Scotia Health Authority for comment, but has yet to receive a response.