Navigating pain management a challenge

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Misuse of opioids often starts innocently enough – but there needs to be greater awareness of the risk and how to address chronic pain, says one stakeholder

While most people recognise the harm caused by illicit drug use including heroin and methamphetamine (Ice), as well as its negative impact across communities, the harm caused by the misuse of opioid medications is not as widely acknowledged, says the Pharmacy Guild’s John Dowling.

Of particular concern is that the incidence of addiction through misuse of opioid medications leading to unintentional overdose has risen in Tasmania over the last 10 years, as outlined by the Penington Institute, he warns.

Guild Tasmanian President John Dowling says that, “the misuse of opioid medications can start innocuously, such as when it is prescribed for people leaving hospital to treat pain after a surgical procedure”.

“If the pain people experience becomes chronic it can, and often does, lead to addiction to opioid and sedative medications such as benzodiazepams like Valium.”

Mr Dowling says that there is a lack of services available in Tasmania to treat chronic pain and associated disorders such as depression.

For many people navigating the various layers of healthcare services to find the help they need is simply too difficult to access or too expensive, he warns.

He highlights that in 2017 pharmacies were restricted from selling Schedule Three opioid medications over the counter and more recently patients receiving prescriptions for opioids have seen a reduction in pack sizes.

Mr Dowling says that while he agrees that these measures can reduce access to opioid medications many people simply turn to something else, such as increased consumption of alcohol or other substances.

In Tasmania people are able to undertake opioid substitution therapy, available through a dosing regime in their local community pharmacy.

However, increased demand for these services requires more GPs to undertake the training available through Tasmania’s Alcohol and Drug Services. This would greatly help with access for those in need, while at the same time sharing the load in treating complex and challenging conditions, Mr Downling suggests.

“Pharmacies are a safe and trusted environment and services are offered discretely to the patient while providing a level of support and encouragement to those undergoing treatment.”

Mr Dowling also reiterated the Guild’s position for the State Government funded Take Home Naloxone trial currently available via Primary Needle and Syringe outlets to be extended across community pharmacy.

“Community pharmacy has needle and syringe pick-ups, offers opioid treatment and are aware of the opioids being prescribed to individuals. This means there is an opportunity for dialogue and engagement with patients about the use of naloxone and how it can save a life.

“It’s about awareness raising,” Mr Dowling said.

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