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Avoiding postsurgery opioids

Re Canadians Fill More Postsurgery Opioid Prescriptions Than Sweden, Study Finds (Sept. 5): I was shocked to see the high number of opioid painkiller prescriptions filled for the relatively minor surgeries listed.

In the past 10 years, I’ve had two of the surgeries mentioned, a Cesarean section and laparoscopic gallbladder removal, as well as a mastectomy. For none of these surgeries was I prescribed opioids; I took a combination of acetaminophen and ibuprofen for a few days.

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To my surprise, I was once prescribed an opioid, tramadol, for abdominal pain at an emergency ward before my gallbladder problem was diagnosed; I never took them. While doctors may be overprescribing postsurgery opioids, it is also incumbent upon the patient to decide if the prescription gets filled.

A little discomfort is expected if you’ve just been cut open, and it isn’t going to kill you.

Tuula Talvila Ottawa

That Canadians fill a high number of opioid prescriptions after surgery sounds as if it is the patient who decides to take these drugs. Really it is a doctor who writes the prescription and a hospital pharmacist who fills it.

Several years ago, after major surgery, a pharmacist came by to ask if I had any allergies to medication, but never discussed the drugs with me. She filled a prescription for 20 tablets of oxycodone without ever discussing its dangers. (I actually experienced little pain and needed to take only one of these pills.)

The pharmacist should have disclosed the risks of opioids. Meanwhile, the doctor should have asked whether I thought I needed these kinds of painkillers in the first place, and offered less addictive choices in order for me to make an informed decision.

The opioid epidemic is a national tragedy, but it is certainly not one caused by those patients who have been given these drugs without any caution.

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Maxanne Ezer Toronto

Before 1995, physicians were too restrained in prescribing opiates such as codeine and morphine. We are now on the other side and want to return to old prescribing habits, which often left patients in pain.

Today, nobody should become addicted to an opioid with one or two weeks’ use after a surgery if they have real pain. The only way people become addicted is by the extension of prescriptions, and only a physician can do that. Drug companies can’t sell an opioid nor can pharmacists dispense one without a physician’s order.

No physician likes denying a patient many times in a day, but they must be tough and prescribe moderately.

D.L. Bythell Retired pharmacist, Port Hope, Ont.

Religion-politics: oil-water

Re Politics Versus Religion (Letters, Sept. 5): Jagmeet Singh’s removal of his turban for an ad signals that the NDP’s brand and his religious brand collided in Quebec. He had to choose, and he did. Although religion is often used as a political platform, religion and politics, like oil and water, generally do not mix unless force is applied, such as in an authoritarian theocracy.

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I wouldn’t be surprised if he presented himself clean-shaven and turban-free – like many successful Sikhs do in this country and elsewhere – in the upcoming debate. He could dazzle other leaders and the electorate, hair down, as a candidate free from religious baggage.

Prad Chaudhuri Mississauga

A is for austerity

Re Jason Kenney’s New Road Map For Austerity (Editorial, Sept. 5): Premier Jason Kenney commissioned a study of Alberta’s fiscal situation that precluded any consideration of tax increases, and the conclusion is that spending must be cut in order to reduce the province’s deficit.

Alberta has for years bragged about its low taxes while it lived off revenues from a boom in the demonstrably cyclical oil industry. And now Mr. Kenney will use this report to force drastic spending cuts upon Albertans – but, heaven forbid, there will be no sales tax or other stable revenue measure.

This is now a knowledge-based world in which oil economies are on a downward trajectory. At a time when Albertans should be spending to invest in themselves, Mr. Kenney would needlessly slash education and others services.

Ross Hedley West Vancouver

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It often seems that talk of “austerity” masks the real issues of governments and their financial objectives. I doubt the real goal of Jason Kenney is to “impose austerity" in Alberta.

What usually underlies austerity, or at least should, is a desire to balance the budget, which means that we are paying for what we are spending. It also means that we are not borrowing money for programs and services, and leaving the debt to be paid by our children. In Mr. Kenney’s case, it also likely means that he thinks Alberta should reduce those programs and services as a matter of political philosophy.

Use of the term austerity casts a negative blanket over the entire issue of government financing. We need more detailed discussion of those goals, and why they are necessary.

Dick Patrick Toronto

Not since the Lougheed years has Alberta’s government seen the need to adapt to our economic roller coaster and mitigate the inevitable crashes. To paraphrase the popular Alberta bumper sticker of that era: “Please God, let there be another oil boom. We promise not to piss it all away next time.”

Leslie Lavers Lethbridge, Alta.

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WWD: Womenswear debate

Re Kids Today (Letters, Sept. 4): Is one letter writer implying that women who show “their décolletage and other eye-catching attributes” are “dressing as [they] do” because they are sexually promiscuous or want to appear as such?

As a young woman, I find this sort of attitude insulting and degrading, particularly when it comes from other women. A person who chooses to show her décolletage, or a modest amount of cleavage, should not be taken any less seriously than one who chooses a higher neckline.

If it is difficult to take such women seriously, I’d say that’s really a “you" problem. Such attitudes reinforce the systems that make it so that appearance affects how we think of others, and how others think of us.

Shulamit Heisler Toronto

The early bird gets the book

Re Smaller Bookstores Speak Out After Amazon Ships Copies Of Atwood’s Testaments Early (Sept. 5): Books have been shipped to bookstores for many years with a “publication date.” The books arrive early, sometimes even a month prior. Many are preordered and paid for; the customer comes in, the book is handed over. It happens every single day.

I look forward to Margaret Atwood’s new book, but all the secrecy and buildup feels like a marketing ploy. The same was done with the Harry Potter series. It makes no difference if it goes out before the official date or not. There will be plenty of copies to go round.

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Alma Javad Burlington, Ont.

Hard-earned advice

Re Don’t Worry, Uni Is Not So Hard (First Person, Sept. 5): Encouraging words for students from Prof. Andrea Chandler in her essay. Conversely, on my very first day of university in 1965, our esteemed English professor said to us: “Look at the person on your left. Now look at the person on your right. One of you will be gone before Christmas.” I for one was petrified, and obviously have never forgotten those words.

Elizabeth Finnie St. Catharines, Ont

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