THUNDER BAY — The Ontario Health Professions Appeal and Review Board has decided to take no further action regarding complaints from a Thunder Bay man whose neurologist declined to prescribe the medication he felt he needed for his headaches.
The case dates back to 2014 when a doctor at a walk-in clinic referred the man to the specialist for evaluation of chronic pain including severe cluster-type headaches, migraine headaches and background headaches.
According to a transcript of the board's ruling, he told the neurologist he was taking numerous medications, including an average of six Tramadol tablets at a time, and "drank alcohol often."
After a neurological exam that found nothing abnormal, the physician prescribed a non-narcotic drug, suggesting the patient's headaches could be induced by the drugs he was taking.
Two months later, the man reported his headaches had worsened. He had been prescribed 100 Tramadol tablets by another doctor, and took 96 of them over a period of nine days.
Although the man insisted he needed immediate relief, including morphine, the neurologist decided to order an MRI brain scan, and referred him to a pain clinic.
The MRI showed normal results, but when the patient complained of throbbing head pain, the doctor ordered further tests to rule out abnormal blood vessels as a possible cause.
After those results, too, proved normal, the man presented the doctor with a letter claiming he had a "constitutional, legal, and fundamental human right to have access to sufficient painkillers to treat his condition."
At the same appointment, he told the neurologist he was drinking alcohol daily and using marijuana.
The specialist then advised him that he would benefit more from the resources and team approach available at a pain management clinic, and offered to refer him to a facility in Toronto.
He replied that if the doctor did not prescribe codeine, he would complain to the College of Physicians and Surgeons.
Subsequently—20 months after she first saw him—the specialist advised the man she would drop him as a patient due to the threat and due to his "ongoing persistence in demanding narcotic drugs."
She said a family physician and a pain specialist should both follow him, and referred him to a clinic in Thunder Bay and to the Toronto pain clinic.
In his complaint to the College, the man said the doctor had not given him painkillers in the dosages he asked for, "inappropriately referred him to other physicians, and inappropriately decided to end their physician-patient relationship."
He also stated that he had suffered severe undue pain from not being provided with medication immediately, and had incurred "a whole myriad of life-threatening problems and other health issues."
The complainant said the neurologist "must" treat him ethically with narcotics and "shouldn't have a choice" since neurologists are the physicians that he needs to see.
Failing to give him narcotics, he said, constituted "deliberate torture."
A committee of the College considered the complaint, determined that the doctor's decision not to prescribe opioids was reasonable, and that the referral to a pain clinic was appropriate.
It also found that the parties' relationship had broken down, which justified its termination.
After considering the patient's appeal, a three-member panel of the Health Professions Appeal and Review Board confirmed the committee's decision on Sept.12.
