Module 1: Professional Accountability and Prescribing

Lesson 6

The Story of SM

“This learning activity is dedicated to SM, a client who died much too young from an illness that could have been treated… if it weren’t for the stigma…”

SM, a 40-year-old client with longstanding mental health and substance use issues, was experiencing a tremendous amount of body pain. He had been treated for a broken bone, and because he admitted that he was alcohol dependent the treating physician prescribed him a small amount of codeine to help with the pain. The doctor advised SM that he was concerned that he might become addicted to the pain drugs, and hence the low dose. After the bone healed, SM was still experiencing a great deal of pain in his back, his ankle where the break had been, and generally all over his body. It was on his medical file that SM was “alcohol and cocaine dependent and at times would present in the hospital in withdrawal, smelling of stale alcohol, anxious, and depressed, although not suicidal.”

SM was told to return if the pain got worse and would be prescribed a low dose of a pain killer or another medication to assist with withdrawal; no other testing was done. Months passed and the pain did not lessen. A health care provider who was working with him took him to hospital and advocated for him to receive further testing. Testing revealed that SM had cancer throughout his whole body and that there was nothing medically that could be done — he died two weeks later.