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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3 Comments

  1. neen
    04/09/2020

    Chronic pain patients rarely become addicted to their pain medications. The studies are clear, but the media keeps perpetuating this myth. HEROIN overdose deaths have surpassed ALL pharmaceutical opioids combined. Why aren’t the media released telling this truth? THere is NO evidence that most people who take pharmaceutical opioids become addicted. This information just isn’t captured READ the penington report. STOP perpetuating these myths. Chronic pain patients are being pushed to suicide because medical professionals, doctors, pharmacists, aren’t bothering to examine the evidence, read the studies and are just believing the headlines that PR consultants write. this IS NOT evidence based. YOu are letting your patients down. There is NO opioid epidemic in Australia. And chronic pain patients are not addicts. Opioids ARE safe and effective for chronic pain in patients with no history of substance abuse. Go do a google scholar search. Stop believing propoganda.

  2. Anne Keogh-Casey
    06/09/2020

    I am another very frustrated and disappointed chronic pain patient due to no fault of my own. I use all the alternative therapies to try and keep my pain under control Plus medication perscribed. I cannot operated my farm chores without them. And no government department is going to provide the manual services to allow me to live. To live in the urban environment I may as well be dead. To take away my pain management will not allow me to live. Many patients should they succome to suicide (and you state use medication) do so BECAUSE THEIR PAIN IS NOT MANAGED APPROPRIATELY… I know, as my Dad suicided because no medical person cared and were willing to listen to him, so there was no point in living. Before you all get excited, there are so many ways to commmit suicide and perscribed medication is a very small portion. For every family complaining their family member suicided, try asking them what they did to know and understand what that person was experiencing, whether is was physical, mental, emotional, financial and I can reassure you all that those needs were not being listened to. And the financial needs also is a huge contributor to suicide.

  3. Jarrod McMaugh
    07/09/2020

    “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.”

    This is a gross oversimplification of the issue, and is basically victim-blaming people when their pain is poorly or even incompetently managed

    one in 5 people in Australia have chronic pain. While people living with chronic pain are at risk of developing substance use disorder, it is far from “often” that it occurs.

    Australia’s strategy for managing chronic pain is woefully inadequate. It consists of delayed diagnoses, stigma associated with seeking treatment, lack of funding for supportive therapies (ie allied health), and an over-reliance on funding for medicines…. which we then tell people they shouldn’t use.

    As a pharmacist I find the attitudes in our profession to people who experience pain or who utilise opioids to be disappointing. The vast majority of people utilise their medicines for pain as prescribed, and if a person develops problematic or disordered use, it is almost always due to poor management of their health – that means as health professionals, we are responsible for the circumstances that lead there.

    I think it’s worth pharmacists having a read of the National Pain Survey from this year, as well as the previous years – http://www.nationalpainweek.org.au/index.php?option=com_content&view=article&id=368

    You will not that there is a significant drop in the perceptions about pharmacists and general practitioners between 2019 to 2020. As a profession, and as part of the wider health care team, we need to do a better job…. how we talk about people who experience pain is part of that.

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