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A Shuswap man, who accused regulators of forcing him to live in severe pain, has had a minor win in court in his legal case over how much pain medication he can take.

According to an April 17 BC Supreme Court decision, Justice Wendy Baker ordered the College of Physicians and Surgeons of BC to disclose all correspondence it has with Rodney Madryga's doctors, so the Shuswap resident can continue his legal action against the regulator.

Madryga's win to have the documental released is a minor step in a case he launched two years ago, accusing the College of Physicians and Surgeons of interfering with his medical care and forcing his doctor to reduce the medication he needs to deal with his chronic pain.

His situation dates back to 1997 when he was permanently injured in a motor vehicle accident at work that left him in continuous severe pain with no prospect of surgical intervention or the pain subsiding.

At the time he was prescribed high doses of opioids that allowed him to continue daily living.

However, some years later in light of the opioid crisis, the College of Physicians and Surgeons began a prescription review program whereby it reviewed how doctors prescribed opioids, sedatives, and other addictive medications.

The College reviewed the dose of medication that Madryga was on and told his doctor that its policy for long-term opiates for non-cancer pain recommended 90 morphine equivalents per day – less than one-fifth of the 500 morphine equivalents per day he was on.

Medical records filed in court show his doctors had absolutely no concerns about Madryga misusing the drugs and the dosage he was on was the minimum effective dose.

However, the College instructed his doctors to follow its recommendations which meant a reduction in the medication.

The court filing gives a window into how his doctors navigated the direction coming from their regulator while trying to take the best care of their patient.

One medical note from his doctor in 2016, shows what effect reducing the medication was having Madryga.

"He feels that he can no longer get out of bed and is unsteady when walking due to pain... he expressed his concerns about his quality of life, he feels it has deteriorated significantly since the minor dosage adjustment I made to his opiates by cutting down on the amount of oxycodone that he gets by a fraction," the doctor's note read.

The decision also shows how his doctors' hands were tied as the College instructed them to follow the policy of reducing the medication.

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"I have again pointed out (to Madryga ) the strongly worded letter that I got from the College that places me in a very difficult position," a doctor's note read.

In 2016, Madryga's care was transferred to a different doctor who noted that he was not getting adequate pain medication, which had left him desperate and contemplating suicide.

In a medical note, the doctor reiterated that Madryga will not get better and that 500 morphine equivalents per day is the correct dose, not the 90 per day the College recommended.

One doctor also had strong words for the College.

"For the past five years, in my experience, the College of Physicians and Surgeons, acting by means of the Prescription Review Program, by imposing considerable administrative burdens on me through the many stages of the Program and threatening referral to the Inquiry Committee for non-compliance, has effectively given me repeated and ongoing specific direction to either reduce Mr. Madryga’s prescription of pain medication, cease my treatment of him, or face further investigation, discipline, and the suspension of my Medical licence, and the associated loss of reputation, status, income, and the continued ability to provide medical services to my patients," the notes read.

In his court case, Madryga said the College is interfering with his medical autonomy and it has no power in law to involve itself in the care given by a doctor to its patient.

Madryga alleged the College "intimidates, harasses and disciplines" physicians who prescribe opioids at levels it doesn't agree with.

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He argued the College must stop interfering with individual medical treatment, cease harassing physicians over high-dose or long-term opiate prescriptions, and cease all investigations, audits, threats, interviews, interrogatories and other administrative action against his doctor related to his care.

He also argued the College’s interference in his care is an infringement of his Charter Rights.

While the court has yet to rule on the case, the College made life more difficult for him by refusing to hand over a number of records which are relevant evidence in the court case.

The College argued the law gave it a blanket exemption not to disclose the records.

However, Justice Baker said the College of Physicians and Surgeons refusal to hand over the paperwork prevented the public from challenging its actions in court.

The Justice said a blanket exemption not to disclose records effectively barred judicial review of the College’s actions.

The Justice found some sections of the Health Care Act were unconstitutional.

Ultimately, the Justice ordered the College to hand over records so Madryga can continue suing the College in his effort to get the correct dosage of pain medication.

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