Opioid prescription meds among most over-prescribed: RACP


codeine tabsules spill from orange pill bottle

The Royal Australasian College of Physicians is calling for greater awareness of the over-prescribing of opioid prescription medication for pain.

RACP President, Laureate Professor Nick Talley, says opioids are now one of the most over-prescribed pain medications in Australia and new evidence suggests their effectiveness in the treatment of long-term pain is limited.

According to the latest National Drug Strategy Household Survey report, the misuse of painkillers increased from 4.8% of the Australian population in 2010, to 7.7% in 2013.

“I think it is now accepted that these drugs have caused significant public health problems, including overdose, and we now need to reign in the problem by cautious prescribing,” Prof Talley says.

RACP Chapter of Addiction Medicine President Dr Matthew Frei says that while long-acting potent opioids are widely used for chronic back or other mechanical pain, the evidence for their long term benefit in non-cancer pain is limited.

Educating doctors and rethinking how pain is treated is one way to reduce inappropriate prescribing, he says.

“Doctors need to plan treatment carefully prior to considering prescribing strong opioids. In the case of non-cancer pain, once pharmaceutical opioid addiction develops, it becomes very hard to manage,” Dr Frei says.

“There needs to be a clear message that these medications are for short-term use, as an adjunct to physical and psychological therapies.”

Prof Talley said our understanding of chronic pain is far more sophisticated today than ever before, for instance we now know that pain is produced in the brain, not directly at the injured body part.

“This new understanding requires a different and comprehensive pain management plan which may include physical exercise, psychological assessment, diet or rehabilitation to treat pain rather than prescribing opioid medication which can ultimately lead to addiction,” Prof Talley says.

“There are many ways to tackle this problem head on, but the approach needs to be collaborative to be effective – everyone has a role including the medical profession, the government and of course individuals and families.

“Access to treatment from an addiction medicine specialist service is essential for people with problem pharmaceutical opioid use,” Prof Talley says.

International Overdose Awareness Day is a global event held on August 31st each year and aims to raise awareness of overdose and reduce the stigma of a drug-related death.

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